inforMED
InjuryEHZ

REF MD5096513

Received Feb 27, 2013 · Event occurred Jan 25, 2013

Report MW5029226 · MDR key 2993991

Device

Generic name

Suction Swab Kit

Model number

1--80196802104

Catalog number

REF MDSO96513

Lot number

12353

Product problems

  • Detachment Of Device Component

Patient

35 YR

  • No Known Impact Or Consequence To Patient

Narrative

Description of Event or Problem

ORAL CARE SPONGE BROKE OFF IN PT'S MOUTH DURING ROUTINE ORAL CARE. THE HEAD OF THE ORAL CARE SPONGE NOTED TO SNAP OFF. DEVICE FAILURE CREATED AN UNSAFE CONDITION. DATES OF USE: (B)(6) 2013 - (B)(6) 2013. EVENT ABATED AFTER USE STOPPED: YES. EVENT REAPPEARED AFTER REINTRODUCTION: YES.