FDA Adverse Event Malfunction Summary report: N

30G DENTAL NDL

MDR report key: 1370680 · Received February 10, 2009

Report

Report Number
1017768-2009-00036
Event Type
Malfunction
Date Received
February 10, 2009
Report Date
February 5, 2009
Manufacturer
COVIDIEN
Product Code
DZM
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

SUBMIT DATE: 02/10/2009. AN INVESTIGATION IS CURRENTLY UNDERWAY; UPON COMPLETION, THE RESULTS WILL BE FORWARDED.

Description of Event or Problem · 1

IT WAS REPORTED TO COVIDIEN IN 2009 THAT A CUSTOMER HAD AN ISSUE WITH A DENTAL NEEDLE. CUSTOMER REPORTS DURING USE, NEEDLE MIGRATED INTO HUB.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 30G DENTAL NDL DENTAL NEEDLE DZM COVIDIEN 8881401072 813050

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN