MAUDE Adverse Event Report: DENTAL DRILL; NONE

Device Problem Insufficient Information (3190)

Patient Problem Partial thickness (Second Degree) Burn (2694)

Event Date 05/20/2014

Event Type  Injury  

Event Description

Visited the dentist to fill cavities and the drill burnt my mouth.I currently have two blisters in my mouth each about 1/4 inch in size.

• Brand Name: DENTAL DRILL
• Type of Device: NONE
• MDR Report Key: 3835626
• MDR Text Key: 4501485
• Report Number: MW5036254
• Device Sequence Number: 1
• Product Code: DZA
• Reporter Country Code: US
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Voluntary
• Reporter Occupation: Patient
• Type of Report: Initial
• Report Date: 05/20/2014

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 05/21/2014
• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Device Operator: Health Professional
• Patient Sequence Number: 1
• Patient Outcome(s): Other
• Patient Age: 37 YR
• Patient Weight: 77