BEUDAMED
    FDA Adverse Event Injury Summary report: N

    AMERICAN

    MDR report key: 212204 · Received March 1, 1999

    Report

    Report Number
    1412902-1999-00006
    Event Type
    Injury
    Date Received
    March 1, 1999
    Date of Event
    January 7, 1999
    Report Date
    February 26, 1999
    Manufacturer
    MPL TECHNOLOGIES
    Product Code
    DZM
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OK, US
    Reporter Occupation
    DENTIST

    Narratives

    Description of Event or Problem · 1

    WHILE PERFORMING A MANDIBULAR BLOCK, THE NEEDLE BROKE OFF AT THE HUB. THE PT WAS REFERRED TO AN ORAL SURGEON. ON THE ADVICE OF THE ORAL SURGEON, THE NEEDLE REMAINED IN THE PT'S GUM TISSUE. THE PT IS ALSO SEEING AN EAR, NOSE, AND THROAT SPECIALIST. THERE HAS BEEN NO CHANGE IN THE PT'S ACTUAL MEDICAL STATUS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 AMERICAN DENTAL NEEDLE DZM MPL TECHNOLOGIES 30G SHORT 13022

    Patients

    Seq Age Sex Outcome Treatment
    1 84 YR Required Intervention