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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DENTSPLY IMPLANTS (A DIVISION OF DENTSPLY IH AB) IMPLANT DRIVER EV (L) WD GS; ACCESSORIES, IMPLANT, DENTAL, ENDOSSEOUS

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DENTSPLY IMPLANTS (A DIVISION OF DENTSPLY IH AB) IMPLANT DRIVER EV (L) WD GS; ACCESSORIES, IMPLANT, DENTAL, ENDOSSEOUS Back to Search Results
Catalog Number 68017003
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 06/11/2026
Type of Reportable Event Malfunction
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Brand Name
IMPLANT DRIVER EV (L) WD GS
Common Device Name
ACCESSORIES, IMPLANT, DENTAL, ENDOSSEOUS
Manufacturer (Section D)
DENTSPLY IMPLANTS (A DIVISION OF DENTSPLY IH AB)
aminogatan 1
molndal vastra gotalands lan [ S-431 21
SW  S-431 21
Manufacturer (Section G)
DENTSPLY IMPLANTS (A DIVISION OF DENTSPLY IH AB)
aminogatan 1
molndal vastra gotalands lan [ S-431 21
SW   S-431 21
Manufacturer Contact
dan eagar
221 west philadelphia st.
york, PA 17401
7178457511
MDR Report Key25811199
Report Number9612468-2026-03580
Device Sequence Number10534912
Product Code NDP
UDI-Device Identifier07392532268953
UDI-Public07392532268953
Combination Product (Y/N)N
Initial Reporter StateNC
Initial Reporter CountryUS
PMA/510(K) Number
EXEMPT
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2026
Device Explanted Year2026
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Dentist
Type of Report Initial
Report Date (Section B) 07/14/2026
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Catalogue Number68017003
Device Lot Number1897791
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer06/22/2026
Is the Reporter a Health Professional? Yes
Distributor Facility Aware Date06/22/2026
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 06/22/2026
Initial Report FDA Received Date07/14/2026
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Reuse
Patient Sequence Number1
Patient SexUnknown
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