BEUDAMED
    FDA Adverse Event Injury Summary report: N

    POWER PROXI SONIC INTERDENTAL SYSTEM POWERED TAPERED BRUSH

    MDR report key: 32871 · Received May 7, 1996

    Report

    Report Number
    MW1009080
    Event Type
    Injury
    Date Received
    May 7, 1996
    Date of Event
    March 10, 1996
    Report Date
    May 1, 1996
    Manufacturer
    DENTIST PREFERRED INC.
    Product Code
    KOJ
    Report Source
    Voluntary report
    Reporter Location
    IL, US
    Reporter Occupation
    DENTIST

    Narratives

    Description of Event or Problem · 1

    PT IS VERY CONCERNED ABOUT HER LOSS. THIS BRUSH SYSTEM HAS A THICK WIRE AND LOOP AT TIP END TO HOLD THE BRISTLES. THE THICK LOOP AT THE TIP IN THIS PT WITH TIGHT INTERDENTAL SPACE HAS CAUSED HER DISCOMFORT. THE PRESSURE ON TISSUE & ESPECIALLY BONE WILL CAUSE IRREPARABLE BONE LOSS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 POWER PROXI SONIC INTERDENTAL SYSTEM POWERED TAPERED BRUSH POWERED,INTERDENTAL,TAPERED BRUSH KOJ DENTIST PREFERRED INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 41 YR Required Intervention