BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PATTERSON 30G SHORT PLASTIC HUB

    MDR report key: 477576 · Received August 13, 2003

    Report

    Report Number
    1412902-2003-00098
    Event Type
    Injury
    Date Received
    August 13, 2003
    Date of Event
    May 19, 2003
    Report Date
    June 30, 2003
    Manufacturer
    MPL
    Product Code
    DZM
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    DENTIST

    Narratives

    Description of Event or Problem · 1

    A NEEDLE BROKE IN THE VESTIBULE TISSUE DURING A PROCEDURE. THE DOCTOR WAS UNABLE TO RETRIEVE THE NEEDLE AND REFERRED THE PATIENT TO AN ORAL SURGEON. THE ORAL SURGEON WAS UNABLE TO RETRIEVE THE NEEDLE AND REFERRED THE PATIENT TO THE HOSPITAL WHERE THE NEEDLE WAS SUGICALLY REMOVED. THE DOCTOR REPORTED THAT HE HAS HAD RECENT CONTACT WITH THE PATIENT AND THE PATIENT IS RECOVERING.

    Devices

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

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Required Intervention