BEUDAMED
    FDA Adverse Event Injury Summary report: N

    KAVO SPRAY AMERICA 2113

    MDR report key: 1209184 · Received October 24, 2008

    Report

    Report Number
    1419798-2008-00021
    Event Type
    Injury
    Date Received
    October 24, 2008
    Date of Event
    September 25, 2008
    Report Date
    September 25, 2008
    Manufacturer
    KALTENBACH & VOIGT GMBH
    Product Code
    EFB
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    VA, US
    Reporter Occupation
    DENTIST

    Narratives

    Description of Event or Problem · 1

    THE DENTAL ASSISTANT WAS SPRAYING A HANDPIECE IN THE SINK WITH KAVO SPRAY AND A BLUE FLAME BURST APPEARED. THE DENTAL ASSISTANT'S HAIR AND EYBROWS WERE SINGED, AND HER LEFT ARM WAS BURNED FROM THE ELBOW DOWN TO NEAR THE WRIST.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KAVO SPRAY AMERICA 2113 DENTAL HANDPIECE AND ACCESSORIES EFB KALTENBACH & VOIGT GMBH 2113 0704021R3

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization| R