inforMED
MalfunctionDZA

PROTAPER SHAPING 1 PTURS121

Received Nov 19, 2021 · Event occurred Nov 2, 2021

Report 2320721-2021-00103 · MDR key 12845010

Device

Generic name

Drill, Dental, Intraoral

Catalog number

PTURS121

Lot number

1666640

Product problems

  • Break
  • Separation Problem
  • Break

Patient

Unknown

  • Device Embedded In Tissue or Plaque
  • Insufficient Information
  • Device Embedded In Tissue or Plaque
  • Insufficient Information

Narrative

Description of Event or Problem

ADDITIONAL INFORMATION RECEIVED INDICATING THE BROKEN PORTION OF THE FILE WAS INCORPORATED INTO THE ROOT CANAL FILLING.

Additional Manufacturer Narrative

A DHR REVIEW WAS CONDUCTED WITH NO DISCREPANCIES NOTED.

Description of Event or Problem

IT WAS REPORTED THAT 4 SEPARATED S-1 FILES IN THE PAST 2 MONTHS REPORTED BY TWO DIFFERENT DOCTORS.

Additional Manufacturer Narrative

AS A RESULT OF THIS MALFUNCTION, THE POTENTIAL FOR SURGICAL INTERVENTION EXISTS TO PRECLUDE PERMANENT DAMAGE TO A BODY STRUCTURE OR PERMANENT IMPAIRMENT OF A BODY FUNCTION AS EVIDENCED BY PREVIOUS REPORTED EVENTS WITH SIMILAR FILES. THIS EVENT, THEREFORE, IS REPORTABLE PER 21CFR PART 803. THE DEVICE WAS NOT RETURNED FOR EVALUATION. HOWEVER, THE LOT NUMBER WAS PROVIDED AND RETAINED-PRODUCT TESTING AND/OR DHR REVIEW ARE PLANNED. THE RESULTS WILL BE SUBMITTED AS THEY BECOME AVAILABLE.