BEUDAMED
    FDA Adverse Event Other Summary report: N

    IMPACT AIR FIBER OPTIC H.P.

    MDR report key: 110918 · Received August 6, 1997

    Report

    Report Number
    2511504-1997-00001
    Event Type
    Other
    Date Received
    August 6, 1997
    Date of Event
    May 16, 1997
    Report Date
    August 5, 1997
    Manufacturer
    GLENWOOD-PALISADES
    Product Code
    DZA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    DENTIST

    Narratives

    Description of Event or Problem · 1

    NOTIFIED BY THE DISTRIBUTOR THAT THE HEAD CAP AND TURBINE CAME OFF IN THE PATIENT'S MOUTH AND WAS REPORTED SWALLOWED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 IMPACT AIR FIBER OPTIC H.P. HANDPIECE DENTAL DRILL DZA GLENWOOD-PALISADES 45 SL *

    Patients

    Seq Age Sex Outcome Treatment
    1 * Other