BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HENRY SCHEIN 30G SHORT METAL HUB

    MDR report key: 440813 · Received January 30, 2003

    Report

    Report Number
    1412902-2003-00001
    Event Type
    Injury
    Date Received
    January 30, 2003
    Date of Event
    December 19, 2002
    Report Date
    January 2, 2003
    Manufacturer
    DENTSPLY MPL TECHNOLOGIES
    Product Code
    DZM
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WV, US
    Reporter Occupation
    DENTIST

    Narratives

    Description of Event or Problem · 1

    DR REPORTED THAT "WHILE PERFORMING A MANDIBULAR BLOCK ON RIGHT SIDE FILLING #32 NEEDLE BROKE AT HUB". ALL NEEDLE FRAGMENTS WERE REMOVED WITHIN AN HOUR AFTER THE INCIDENT BY AN ORAL SURGEON.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HENRY SCHEIN 30G SHORT METAL HUB DENTAL NEEDLE DZM DENTSPLY MPL TECHNOLOGIES NA 5032

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Required Intervention