BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    TRADITION

    MDR report key: 392362 · Received April 29, 2002

    Report

    Report Number
    1419322-2002-00014
    Event Type
    Malfunction
    Date Received
    April 29, 2002
    Date of Event
    April 17, 1998
    Report Date
    April 26, 2002
    Manufacturer
    MIDWEST DENTAL PRODUCTS
    Product Code
    EFB
    Removal / Correction Number
    1013695
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SD, US
    Reporter Occupation
    DENTIST

    Narratives

    Description of Event or Problem · 1

    A DENTIST ALLEGES THAT A DENTAL BUR CAME OUT OF HTE HANDPIECE, JUMPED TO THE BACK OF THE THROAT, AND WAS SUBSEQUENTLY SWALLOWED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TRADITION DENTAL HANDPIECE EFB MIDWEST DENTAL PRODUCTS NA NA

    Patients

    Seq Age Sex Outcome Treatment
    1 3 YR Other