FDA Adverse Event Injury Summary report: N

GENTLEPOWER LUX CONTRA ANGLE 25LPA

MDR report key: 839572 · Received April 12, 2007

Report

Report Number
1419798-2007-00014
Event Type
Injury
Date Received
April 12, 2007
Date of Event
March 21, 2007
Report Date
April 11, 2007
Manufacturer
KAVO AMERICA
Product Code
EKK
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CT, US
Reporter Occupation
DENTIST

Narratives

Additional Manufacturer Narrative · 1

HEAD IS DAMAGED DUE TO MULTIPLE DENTS BEARINGS/ GEARS ARE WORN AND GRITTY IN DRIVE ASSEMBLY AND SHAFT HAD HEAVY DEBRIS. MAINTENANCE INFORMATION WAS REVIEWED WITH THE DOCTOR AND MAINTENANCE SHEETS WERE SENT.

Description of Event or Problem · 1

THE HANDPIECE BECAME HOT AND BURNED THE PATIENT LIP. THE BURNS WERE SLIGHTLY LARGER THAN HANDPIECE HEAD. OINTMENT WAS APPLIED TO THE BURN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GENTLEPOWER LUX CONTRA ANGLE 25LPA OPERATIVE DENTAL UNIT ACCESSORY EKK KAVO AMERICA 25LPA *

Patients

Seq Age Sex Outcome Treatment
1 YR Required Intervention