Medical Device
Manufacturing
THE TRADE PAPER OF THE FACTORY FLOOR
Z-1822-2012Class II

Peak SE Primer Kits (4 syringes per kit) manufactured by Ultradent Products, Inc, South Jordan, UT, Self Etch...

Ultradent Products Inc. / initiated 2012-05-24 / Terminated / root cause: labeling and UDI

Ultradent Products, Inc. began a recall of Peak SE Primer Kits (4 syringes per kit) manufactured by Ultradent Products, Inc, South Jordan, UT, Self Etch Primer. The product is contained within... on . FDA classified it as Class II and gives the reason as "Ultradent is recalling lot B6Z4K of Peak SE Primer as a result of a field complaint, dated May 10, 2012, stating that a syringe of Peak SE Primer was mislabeled as Peak LC Bond Resin. These products are used by Dental...". As of , the recall status on record is Terminated, and MDM tags the root cause as labeling and UDI.

Recall record

Recall number
Z-1822-2012
Classification
Class II
Status
Terminated
Initiated
Posted
Terminated
Recalling firm
Ultradent Products Inc.
Product
Peak SE Primer Kits (4 syringes per kit) manufactured by Ultradent Products, Inc, South Jordan, UT, Self Etch Primer. The product is contained within prefilled, labeled syringes in a transparent plastic container identified with an aqua, red, orange, blue and black label with black and blue print writing. Product code: 5135, 872.3200 KLE, liquid and powder mixture is a syringe-in-a-syringe delivery system. The product is used for most bonding needs in restorative dentistry. Bonds chemical cure luting and chemical cure composites, namely PermaFlo DC. Peak SE does not require a separate etching step for quality adhesion. Peak SE is also conducive for bonding to: Dentin and enamel, porcelain, metal and composite.
Product code
KLE Agent, Tooth Bonding, Resin
Reason for recall
Ultradent is recalling lot B6Z4K of Peak SE Primer as a result of a field complaint, dated May 10, 2012, stating that a syringe of Peak SE Primer was mislabeled as Peak LC Bond Resin. These products are used by Dental professionals for bonding needs in restorative dental procedures.
Root cause tag
labeling and UDI
FDA root cause
Labeling mix-ups
Action
Ultradent Products Inc. sent an "URGENT MEDICAL DEVICE RECALL" letter dated June 5, 2012 to all affected customers. The letter identifies the product, problem, and actions to be taken by the customers. The letter instructs customers to discard any affected product from their 5135 kit. Customers were asked to complete and return a Recall Return Response form to the firm by fax at 801-553-4609.
Quantity in commerce
172 kits (4 syringes per kit)
Distribution
Worldwide Distribution.
Product codes and lots
Lot number: B6Z4K.

Enforcement reports

One row per recalled product line
FDA enforcement reports joined to recall event Z-1822-2012
Recall numberClassStatusVoluntary or mandatedReport dateClassified
Z-1822-2012Class IITerminatedVoluntary: Firm initiated