BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    PATTERSON DENTAL NEEDLE

    MDR report key: 401203 · Received June 18, 2002

    Report

    Report Number
    1412902-2002-00030
    Event Type
    Malfunction
    Date Received
    June 18, 2002
    Date of Event
    March 5, 2002
    Report Date
    June 18, 2002
    Manufacturer
    MPL TECHNOLOGIES
    Product Code
    DZM
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NC, US
    Reporter Occupation
    DENTIST

    Narratives

    Description of Event or Problem · 1

    THE HUB ALLEGEDLY SEPARATED FROM THE NEEDLE AND BROKE OFF IN THE PATIENT'S MOUTH.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PATTERSON DENTAL NEEDLE DENTAL NEEDLE DZM MPL TECHNOLOGIES 30 G SHORT PLASTIC HUB UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other