inforMED
InjuryEFS

WATER PIK WATER FLOSSER

Received Nov 16, 2020 · Event occurred Nov 5, 2020

Report 1712259-2020-00010 · MDR key 10848508

Device

Generic name

Oral Irrigator

Manufacturer

Water Pik Inc

Model number

WP-140

Lot number

191202CJ

Product problems

  • Adverse Event Without Identified Device or Use Problem

Patient

Not reported

  • Tooth Fracture
  • Tooth Fracture

Narrative

Description of Event or Problem

ON SUNDAY WHILE USING THE MACHINE I FELT THE PIECE OF VENEER COME OFF IN MY MOUTH. I HAVE ATTACHED A PHOTO OF THE CHIP BELOW. THE DENTIST SAID IT CANNOT BE REPAIRED. BEING A VENEER MY INSURANCE PROVIDER WILL NOT COVER REPLACEMENT. THEY PURPOSE A CROWN. MY WORK NORMALLY WOULD COVER 50% FOR CROWNS UP TO A SPECIFIC AMOUNT. I HAVE ATTACHED THE OTHER CROWN FOR REFERENCE ONLY SINCE IT IS ON THE SAME QUOTE. THE MEDAL IS SHOWING AS YOU CAN SEE, SO I THOUGHT I WOULD ASK ABOUT THAT ONE, WHILE I WAS THERE. IT IS ALSO LISTED ON THE ESTIMATE. IT IS APPROXIMATELY (B)(6) DEPENDING ON LAB FEES FOR THE ONE CROWN. THEY CHARGED ME FOR THE EMERGENCY VISIT TODAY WITH XRAYS, AND MY WORK ONLY COVERS UP TO 80%. I PAID (B)(6) OUT OF MY OWN POCKET. I WOULD LIKE TO BE REIMBURSED FOR THE VISIT THIS MORNING AND BE REIMBURSED 50% FOR THE REPLACEMENT CROWN. MY VENEER WAS IN PERFECT CONDITION PRIOR TO USING THE MACHINE. I PURCHASED IT ON THE RECOMMENDATION OF MY DENTAL HYGIENIST." CLAIM PROCEEDINGS WERE DELAYED INITIALLY AS CUSTOMER WAS ON VACATION, AND FURTHERMORE AS THE PRODUCT WAS GIVEN TO A FAMILY MEMBER AFTER THE INCIDENT AND HAD TO BE RETRIEVED.

Remedial action

  • Other