FDA Adverse Event Injury Summary report: N

MICRO DRILL MEDIUM STRAIGHT ATTACHMENT

MDR report key: 1151465 · Received September 5, 2008

Report

Report Number
1811755-2008-00051
Event Type
Injury
Date Received
September 5, 2008
Date of Event
August 8, 2008
Report Date
September 5, 2008
Manufacturer
STRYKER INSTRUMENTS KALAMAZOO
Product Code
HBB
PMA / PMN Number
K040300
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE RISK MANAGER AT THE HOSPITAL WOULD NOT RELEASE THE PRODUCT FOR INVESTIGATION. THE FAILURE CAN NOT BE CONFIRMED WITHOUT THE DEVICE.

Description of Event or Problem · 1

IT WAS REPORTED THAT WHILE USING A DRILL AND ATTACHMENT DURING A DENTAL PROCEDURE, A PT RECEIVED A BLISTER ABRASION ON THE MUCOSA SIDE OF THE MOUTH. VASELINE WAS APPLIED AT THE TIME OF THE INCIDENT AND NO FURTHER TREATMENT IS EXPECTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MICRO DRILL MEDIUM STRAIGHT ATTACHMENT CORE/MICRO POWER INSTRUMENTS AND ACCESSORIES HBB STRYKER INSTRUMENTS KALAMAZOO 07240

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention