FDA Adverse Event Injury Summary report: N

GENTLEPOWER LUX CONTRA ANGLE 25LPA

MDR report key: 1361984 · Received April 15, 2009

Report

Report Number
8010493-2009-00008
Event Type
Injury
Date Received
April 15, 2009
Date of Event
March 18, 2009
Report Date
March 18, 2009
Manufacturer
KALTENBACH & VOIGT GMBH
Product Code
EFB
PMA / PMN Number
K073478
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
DENTIST

Narratives

Additional Manufacturer Narrative · 1

PATIENT WAS PRESCRIBED 600MG IBUPROFEN AND 20% BENZOCAINE GEL. PATIENT WAS ALSO ADVISED TO RINSE WITH WARM SALT WATER. PATIENT HAS COMPLETELY HEALED. DURING THE HANDPIECE EVALUATION, IT WAS FOUND THAT THE BEARINGS WERE WORN, AND GRITTY IN THE DRIVE ASSEMBLY, SHAFT AND AXLE, THE HEAD WAS DENTED, AND MEDIUM DEBRIS WAS PRESENT.

Description of Event or Problem · 1

WHILE THE DOCTOR WAS WORKING ON TOOTH #3, THE PATIENT'S CHEEK WAS BURNED 10MM BY 5MM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GENTLEPOWER LUX CONTRA ANGLE 25LPA DENTAL HANDPIECE AND ACCESSORIES EFB KALTENBACH & VOIGT GMBH 25LPA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention