FDA Adverse Event Other Summary report: N

MEDI-PLUS

MDR report key: 731935 · Received February 6, 2006

Report

Report Number
731935
Event Type
Other
Date Received
February 6, 2006
Date of Event
November 15, 2005
Report Date
February 6, 2006
Manufacturer
BRASSELER USA
Product Code
DZA
Report Source
User Facility report
Reporter Location
NY, US

Narratives

Description of Event or Problem · 1

PATIENT UNDERWENT OR GNETA (GENERAL ENDOTRACHEAL ANESTHESIA) FOR THE EXTRACTION OF AN IMPACTED WISDOM TOOTH. THE TIP OF THE TAPERED CARBIDE BUR WAS NOTICED TO BE MISSING FROM THE SHAFT BY THE SURGEON.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MEDI-PLUS TIP, DENTAL DZA BRASSELER USA 04CO607 Z9296

Patients

Seq Age Sex Outcome Treatment
1 16 YR NO OTHER THERAPIES