FDA Adverse Event Injury Summary report: N

SCHEIN K-FILE 21MM SZ 15

MDR report key: 3647941 · Received February 6, 2014

Report

Report Number
2523190-2014-00009
Event Type
Injury
Date Received
February 6, 2014
Report Date
January 29, 2014
Manufacturer
INTEGRA YORK, PA INC
Product Code
EKS
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

TO DATE, THE DEVICE INVOLVED IN THE REPORTED INCIDENT HAS NOT BEEN REC'D FOR EVALUATION. AN INVESTIGATION HAS BEEN INITIATED BASED ON THE REPORTED INFO.

Description of Event or Problem · 1

CUSTOMER INITIALLY REPORTS THAT THE FILE BROKE IN THE ROOT OF THE TOOTH DURING USE. PATIENT NEEDED TO SEE A SPECIALIST BECAUSE OF THE DAMAGE. ON (B)(6) 2014, CUSTOMER REPORTS DOCTOR WAS PERFORMING A ROOT CANAL WHEN THE DEVICE BROKE OFF IN THE ROOT, THE PART REMAINS IN THE ROOT. PATIENT IS TO SEE AN ENDODONTIST. ANTIBIOTICS WERE PRESCRIBED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
77567 SCHEIN K-FILE 21MM SZ 15 M50 - ENDODONTICS EKS INTEGRA YORK, PA INC

Patients

Seq Age Sex Outcome Treatment
1