MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional report with the FDA on 2020-02-28 for TOOL OCTAGON 3MM 29MM SST OTL3.0-S manufactured by Zimmer Dental.
[182190157]
Zimmer biomet complaint (b)(4). Patient identifier is not provided / unknown. Patient weight is not provided / unknown. Initial reporter? S title first name last name and email address are not provided / unknown.
Patient Sequence No: 1, Text Type: N, H10
[182190158]
Doctor indicated that during the surgery, the otl3. 0-s insertion tool was stuck in the implant. Doctor used another tool and another implant in stock to complete the procedure. Tooth location # 3.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 0002023141-2020-00433 |
| MDR Report Key | 9769624 |
| Report Source | FOREIGN,HEALTH PROFESSIONAL |
| Date Received | 2020-02-28 |
| Date of Report | 2020-02-28 |
| Date of Event | 2020-01-31 |
| Date Mfgr Received | 2020-02-05 |
| Date Added to Maude | 2020-02-28 |
| 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 | 3 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MS SUSANNE TAYLOR |
| Manufacturer Street | 4555 RIVERSIDE DRIVE |
| Manufacturer City | PALM BEACH GARDENS FL 33410 |
| Manufacturer Country | US |
| Manufacturer Postal | 33410 |
| Manufacturer Phone | 5617766700 |
| Manufacturer G1 | ZIMMER DENTAL |
| Manufacturer Street | 4555 RIVERSIDE DRIVE |
| Manufacturer City | PALM BEACH GARDENS FL 33410 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 33410 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | TOOL OCTAGON 3MM 29MM SST |
| Generic Name | DENTAL TOOL |
| Product Code | NDP |
| Date Received | 2020-02-28 |
| Returned To Mfg | 2020-02-05 |
| Catalog Number | OTL3.0-S |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Eval'ed by Mfgr | N |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ZIMMER DENTAL |
| Manufacturer Address | 4555 RIVERSIDE DRIVE PALM BEACH GARDENS FL 33410 US 33410 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2020-02-28 |