inforMED
InjuryEMS

MINI FIVE GRACEY CURETTE

Received Mar 14, 2019 · Event occurred Jan 29, 2019

Report 1416605-2019-00005 · MDR key 8423390

Device

Generic name

Curette, Periodontic

Model number

SAS1/271

Catalog number

SAS1/271

Lot number

T3

Product problems

  • Material Fragmentation
  • Material Fragmentation

Patient

52 YR

  • No Known Impact Or Consequence To Patient
  • No Known Impact Or Consequence To Patient

Narrative

Additional Manufacturer Narrative

PATIENT WEIGHT, ETHNICITY AND RACE UNKNOWN. THERE IS NO RELEVANT HISTORY. BASED ON THE LOT NUMBER OF THE DEVICE, THIS DEVICE WAS PRODUCED PRIOR TO THE UDI DEADLINE FOR CLASS I, THEREFORE UDI IS NOT PRESENT. THE DEVICE IS NOT IMPLANTED, THEREFORE IMPLANT/EXPLANT DATES ARE NOT APPLICABLE. REPROCESSOR DOES NOT APPLY. NO KNOWN CONCOMITANT MEDICAL PRODUCTS AND THERAPY DATES. USER FACILITY/IMPORTER DOES NOT APPLY. IND IS NOT APPLICABLE. NOT APPLICABLE.

Description of Event or Problem

DURING A SURGICAL CLEANING ((B)(6) 2019) OF THE FURCATION AREA ON TOOTH 46, THE TIP FRACTURED OFF AND WAS LEFT IN SITU. PATIENT WAS ADVISED OF PROBLEM AND DENTIST WANTED TO SEE IF SHE HEALED AND TIP APPEARED. IT DID NOT, SO SHE RETURNED TO OFFICE AND IT WAS REMOVED SURGICALLY ON (B)(6) 2019.