BEUDAMED
    FDA Adverse Event Injury Summary report: N

    DENTAL DRILL

    MDR report key: 3835626 · Received May 21, 2014

    Report

    Report Number
    MW5036254
    Event Type
    Injury
    Date Received
    May 21, 2014
    Date of Event
    May 20, 2014
    Report Date
    May 20, 2014
    Product Code
    DZA
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NV, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    VISITED THE DENTIST TO FILL CAVITIES AND THE DRILL BURNT MY MOUTH. I CURRENTLY HAVE TWO BLISTERS IN MY MOUTH EACH ABOUT 1/4 INCH IN SIZE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    303026 DENTAL DRILL NONE DZA

    Patients

    Seq Age Sex Outcome Treatment
    1 37 YR Other