MalfunctionJEW

STAR

Received Sep 1, 1994 · Event occurred Nov 5, 1993

Report 2411236-1993-00242 · MDR key 22854

Device

Generic name

Titans Perio Tip

Manufacturer

Star Dental

Model number

#61669

Catalog number

808-4911

Patient

Narrative

Description of Event or Problem

REGISTERED HYGENIST WAS DOING ROUTINE PROPHY ON UPPER RIGHT QUADRANT WHEN APPROXIMATELY 4MM OF SCALER TIP BROKE OFF INPT'S MOUTH AND WAS EVACUATED BY ASPIRATOR. PT WAS NOT INJURED. TIP HAD BEEN WORKING NORMALLY UP TO THE MOMENT IT BROKE.