MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 1997-09-26 for MILTEX 76-70 SAME manufactured by Miltex Instrument Co..
[100682]
Dr was administering medication when finger ring broke in half causing injury to the dr. Very slight cut occurred at thumb crease. Bandage was applied, no further action was required.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 2431021-1997-00010 |
| MDR Report Key | 122689 |
| Report Source | 05 |
| Date Received | 1997-09-26 |
| Date of Report | 1997-09-26 |
| Date of Event | 1997-09-25 |
| Date Mfgr Received | 1997-09-25 |
| Date Added to Maude | 1997-09-30 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 0 |
| Reporter Occupation | DENTIST |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 0 |
| Single Use | 3 |
| Remedial Action | NO |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | MILTEX |
| Generic Name | ASPIRATING SYRINGE |
| Product Code | EJI |
| Date Received | 1997-09-26 |
| Model Number | 76-70 |
| Catalog Number | SAME |
| Lot Number | UNK |
| ID Number | * |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Implant Flag | N |
| Date Removed | A |
| Device Sequence No | 1 |
| Device Event Key | 120160 |
| Manufacturer | MILTEX INSTRUMENT CO. |
| Manufacturer Address | 6 OHIO DR. CB5006 LAKE SUCCESS NY 110420006 US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 1997-09-26 |