BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PATTERSON 30G SHORT PLASTIC HUB

    MDR report key: 490709 · Received October 22, 2003

    Report

    Report Number
    1412902-2003-00167
    Event Type
    Injury
    Date Received
    October 22, 2003
    Date of Event
    August 25, 2003
    Report Date
    September 22, 2003
    Manufacturer
    DENTSPLY MPL TECHNOLOGIES
    Product Code
    DZM
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MI, US
    Reporter Occupation
    DENTIST

    Narratives

    Description of Event or Problem · 1

    A NEEDLE BROKE OFF IN THE PT'S TISSUE DURING A PROCEDURE AND NEEDED TO BE SURGICALLY REMOVED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PATTERSON 30G SHORT PLASTIC HUB DENTAL NEEDLE DZM DENTSPLY MPL TECHNOLOGIES NA 8040

    Patients

    Seq Age Sex Outcome Treatment
    1 61 YR Required Intervention