InjuryDYJ
BILATERAL DISTAL JET
Received Aug 21, 2024 · Event occurred Jul 29, 2024
Report 2184045-2024-00002 · MDR key 20021099
Device
Generic name
Distal Jet
Manufacturer
Allesee Orthodontic AppliancesCatalog number
3000-0090
Lot number
32632146
Product problems
- Detachment of Device or Device Component
- Detachment of Device or Device Component
Patient
10 YR · Female
- Appropriate Clinical Signs, Symptoms and Conditions Term/Code Not Available
- Appropriate Clinical Signs, Symptoms and Conditions Term/Code Not Available
Narrative
Description of Event or Problem
DOCTOR ALLEGES A BILATERAL DISTAL JET APPLIANCE CAME APART IN THE PATIENT'S MOUTH. DURING REMOVAL OF THE APPLIANCE, THE PATIENT SWALLOWED THE SPRING. THE PATIENT CONFIRMED THE SPRING PASSED NATURALLY WITHOUT INCIDENT.
Remedial action
- Other