FDA Adverse Event Malfunction Summary report: N

DRILL/BURR ATTACHMENT FOR 2.35MM SHAFTS

MDR report key: 3121513 · Received May 21, 2013

Report

Report Number
8030965-2013-02298
Event Type
Malfunction
Date Received
May 21, 2013
Date of Event
April 22, 2013
Report Date
April 23, 2013
Manufacturer
SYNTHES GMBH
Product Code
HWE
PMA / PMN Number
K043310
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. DEVICE IS AN INSTRUMENT AND IS NOT IMPLANTED/EXPLANTED. THE INVESTIGATION COULD NOT BE COMPLETED; NO CONCLUSION COULD BE DRAWN, AS NO PRODUCT WAS RECEIVED. THE MANUFACTURING DOCUMENTS WERE REVIEWED AND NO COMPLAINT RELATED ISSUES WERE FOUND.

Additional Manufacturer Narrative · 1

DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. UPON FURTHER REVIEW OF THE COMPLAINT, IT WAS DETERMINED THE COMPLAINT IS NOT REPORTABLE DUE TO: DOES NOT MEET THE DEFINITION OF AN MDR REPORTABLE EVENT. NOT LIKELY TO RESULT IN PATIENT HARM OR THE NEED FOR ADDITIONAL MEDICAL OR SURGICAL INTERVENTION. THE MDR REPORT ABILITY STATUS UPDATED TO: DOES NOT MEET THE DEFINITION OF A REPORTABLE EVENT. SYNTHES IS RETRACTING MEDWATCH REPORT: #8030965-2013-02298.

Description of Event or Problem · 1

DURING A DENTAL IMPLANT PROCEDURE ON (B)(6) 2013, REPORTEDLY TWO SEPARATE E-PEN ATTACHMENTS (DRILL/BURR ATTACHMENT FOR 2.35MM SHAFTS) DID NOT FUNCTION. IT WAS REPORTED A THIRD ATTACHMENT WAS USED TO COMPLETE THE PROCEDURE WITH NO FURTHER PROBLEM. NO HARM TO THE PATIENT WAS REPORTED. NO ADDITIONAL INFORMATION WAS PROVIDED. THIS IS 1 OF 2 REPORTS FOR THE SAME EVENT, COMPLAINT (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
224534 DRILL/BURR ATTACHMENT FOR 2.35MM SHAFTS HWE SYNTHES GMBH 1408

Patients

Seq Age Sex Outcome Treatment
1