BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PATTERSON BRAND WITH AFFIXED TIP

    MDR report key: 490578 · Received September 30, 2003

    Report

    Report Number
    MW1029788
    Event Type
    Injury
    Date Received
    September 30, 2003
    Date of Event
    August 19, 2003
    Report Date
    September 22, 2003
    Manufacturer
    PATTERSON DENTAL SUPPLY COMPANY
    Product Code
    DYN
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    RI, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    TIP OF DENTAL SUCTION FOUND IN PT'S THROAT DURING INTUBATION. REMOVED WITH NO INJURY TO PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PATTERSON BRAND WITH AFFIXED TIP SALIVA EJECTOR DYN PATTERSON DENTAL SUPPLY COMPANY 089-4097 *

    Patients

    Seq Age Sex Outcome Treatment
    1 54 YR Required Intervention