FDA Adverse Event
Injury
Summary report: N
PATTERSON
MDR report key: 54922
·
Received December 12, 1996
Report
- Report Number
- 1412902-1996-00004
- Event Type
- Injury
- Date Received
- December 12, 1996
- Date of Event
- November 18, 1996
- Report Date
- December 11, 1996
- Manufacturer
- MPL TECHNOLOGIES, INC.
- Product Code
- DZM
- Removal / Correction Number
- NA
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IL, US
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
DURING A LOWER MANDIBULAR BLOCK ANESTHETIC INJECTION, DR. WITHDREW NEEDLE AND REALIZED IT WAS BROKEN OFF AT THE HUB. THE NEEDLE WAS EMBEDDED IN THE PT'S GUM TISSUE. DR WAS UNABLE TO REMOVE THE NEEDLE AND CONSULTED A SURGEON TO REMOVE IT. THERE WERE NO REPORTED COMPLICATIONS AND THE PT HAS FULLY RECOVERED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | PATTERSON | DENTAL NEEDLE | DZM | MPL TECHNOLOGIES, INC. | PP57830 | 12527 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 4 YR | Required Intervention |