inforMED
OtherEJB

HU-FRIEDY BRACKET REMOVER

Received Jun 11, 2012 · Event occurred Mar 23, 2012

Report 1416605-2012-00002 · MDR key 2625834

Device

Generic name

678-220l

Model number

678-220L

Catalog number

678-220L

Lot number

T5

Product problems

  • Break

Patient

15 YR

  • Tooth Fracture

Narrative

Description of Event or Problem

ON (B)(6) 2012 THE PATIENT WAS HAVING BRACKETS REMOVED, THE PLIER BEING USED BROKE AND CAUSED A HORIZONTAL FRACTURE ON TOOTH NUMBER 12. THE TOOTH WAS TEMPORARY FIXED AND THE PATIENT WAS SENT TO THE (B)(6) MEDICAL CENTER OF THE UNIVERSITY OF (B)(6) WHERE A ROOT CANAL TREATMENT WAS PERFORMED ON TOOTH.

Remedial action

  • Other