BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BENCO 30G SHORT PLASTIC HUB NEEDLE

    MDR report key: 509910 · Received January 13, 2004

    Report

    Report Number
    1412902-2004-00007
    Event Type
    Malfunction
    Date Received
    January 13, 2004
    Report Date
    December 8, 2003
    Manufacturer
    DENTSPLY MPL
    Product Code
    DZA
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MD, US
    Reporter Occupation
    DENTIST

    Narratives

    Description of Event or Problem · 1

    THE DOCTOR REPORTED THAT A NEEDLE BROKE OFF IN THE PT'S MOUTH. THE PT WAS REFERRED TO AN ORAL SURGEON FOR SURGICAL REMOVAL OF THE NEEDLE. THE ORAL SURGEON ELECTED TO NOT REMOVE THE NEEDLE AT THIS TIME DUE TO THE LOCATION NEAR A NERVE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BENCO 30G SHORT PLASTIC HUB NEEDLE DENTAL NEEDLE DZA DENTSPLY MPL NA 8876

    Patients

    Seq Age Sex Outcome Treatment
    1 15 YR Other