MalfunctionEKD
ADSN TISS FCPS 4-3/4 1X2
Received Jun 26, 2014 · Event occurred Jun 2, 2014
Report 2523190-2014-00047 · MDR key 3958804
Device
Product problems
- Break
Patient
30 YR
- No Known Impact Or Consequence To Patient
Narrative
Additional Manufacturer Narrative
TO DATE, THE DEVICE INVOLVED IN THE REPORTED INCIDENT HAS NOT BEEN RECEIVED FOR EVALUATION. AN INVESTIGATION HAS BEEN INITIATED BASED ON THE REPORTED INFO.
Description of Event or Problem
CUSTOMER INITIALLY REPORTS TEETH BROKE WHILE TREATING PT. ON (B)(6) 2014, CUSTOMER REPORTS TIP FROM THE ONE TOOTH SIDE OF FORCEP BROKE OFF IN PT LIP WHEN A BIOPSY WAS BEING TAKEN. TIP WAS REMOVED EASILY. NO HARM TO PT. EVENT DATE NOT AVAILABLE, (B)(6).