FDA Adverse Event Injury Summary report: N

TAPERED HEX SCREW

MDR report key: 1797579 · Received August 12, 2010

Report

Report Number
2917088-2010-00008
Event Type
Injury
Date Received
August 12, 2010
Report Date
July 14, 2010
Manufacturer
ATTACHMENTS INTL., INC.
Product Code
EGG
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
DENTIST

Narratives

Additional Manufacturer Narrative · 1

A DOCTOR REPORTED THAT A TAPERED HEX SCREW BROKE IN A PATIENT'S MOUTH. THE DOCTOR STATED THAT THE BREAK WAS DISCOVERED DURING A ROUTINE VISIT WHEN HE NOTICED THAT THE PATIENT'S BRIDGE WAS LOOSE. THE DOCTOR REPLACED THE BROKEN SCREW AND THE PATIENT IS DOING FINE. AN EVALUATION ON THE RETURNED SCREW CONFIRMED THAT THE SCREW HAD NO DEFECTS AND MET PRODUCT SPECIFICATIONS. THE EXACT CAUSE OF THE SCREW FRACTURE COULD NOT BE DETERMINED; HOWEVER, A REVIEW OF THE MANUFACTURING RECORDS WAS CONDUCTED AND NO IRREGULARITIES OR DEVIATIONS WERE FOUND. THIS IS NOT A PRODUCT FAILURE.

Description of Event or Problem · 1

ON (B)(6), 2010, A DOCTOR REPORTED TO ATTACHMENTS INTERNATIONAL, INC. THAT A HEX SCREW BROKE IN A PATIENT'S MOUTH.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TAPERED HEX SCREW PRECISION ATTACHMENT EGG ATTACHMENTS INTL., INC. 042308-20A

Patients

Seq Age Sex Outcome Treatment
1 Other