inforMED
MalfunctionNOF

CS 3600 SINGLE USE NORMAL TIPS

Received Feb 23, 2021 · Event occurred Jan 25, 2021

Report 1317307-2021-00001 · MDR key 11366583

Device

Generic name

Cs 3600 Single Use Normal Tips

Model number

CS 3600

Catalog number

5941216

Lot number

2020-06

Product problems

  • Material Separation
  • Defective Component
  • Material Separation
  • Defective Component

Patient

Not reported

  • Foreign Body In Patient
  • Foreign Body In Patient

Narrative

Description of Event or Problem

WHEN USING THE CS 3600 ACCESSORY: CS 3600 SINGLE USE NORMAL TIP, THE MIRROR CAN BE DETACHED FROM THE UNIT. WHEN THIS EVENT OCCURRED, THE MIRROR FELL FROM THE UNIT INTO THE PATIENT'S MOUTH. THE PATIENT WAS ABLE TO REMOVE THE MIRROR AND THE PATIENT DID NOT SUSTAIN ANY INJURIES. THE SIZE OF THE MIRROR (22MMX13MMX1.5MM) MAKES IT POSSIBLE FOR THE MIRROR TO BE SWALLOWED OR ASPIRATED. IF THE MIRROR IS SWALLOWED OR ASPIRATED, SURGICAL INTERVENTION WOULD BE REQUIRED TO REMOVE THE MIRROR.

Remedial action

  • Recall