OtherDYN

PATTERSON BRAND

Received Mar 16, 2004 · Event occurred Mar 5, 2004

Report MW1031568 · MDR key 519485

Device

Generic name

Saliva Ejector With Fixed Tip

Manufacturer

Patterson Dental Supply

Model number

Catalog number

Lot number

Product problems

Component Falling
Tip breakage
Use of Device Problem

Patient

39 YR

Therapy/non-surgical treatment, additional

Narrative

Description of Event or Problem

WHILE COMPLETING MOUTH CARE, PT BIT DOWN ON END OF WHITE TONSIL SUCTION DISLODGING SMALL SUCTION TIP PIECE FROM STRAW PORTION OF SUCTION CATHETER. UNABLE TO LOCATE DISLODGED TIP IN PT'S MOUTH. TIPS RETRIEVED VIA BRONCHOSCOPY.