inforMED
InjuryEMA

IRM ZOE INTERMEDIATE RESTORATIVE MATERIAL

Received Jan 6, 2021

Report 2515379-2020-00015 · MDR key 11128707

Device

Generic name

Cement, Dental

Model number

NA

Catalog number

610007

Lot number

UNK

Product problems

  • Patient-Device Incompatibility
  • Patient-Device Incompatibility

Patient

Not reported

  • Hypersensitivity/Allergic reaction
  • Hypersensitivity/Allergic reaction

Narrative

Additional Manufacturer Narrative

WHILE IT IS UNKNOWN IF THE DEVICE USED IN THIS CASE CAUSED OR CONTRIBUTED TO THE PATIENT'S SYMPTOMS, IT IS POSSIBLE AS ALLERGIC REACTIONS TO DENTAL MATERIALS ARE KNOWN AND REPORTED, WITH MEDICAL CONSEQUENCES BEING DEPENDENT UPON THE SEVERITY OF THE INDIVIDUAL ALLERGIC RESPONSE AND SUBSEQUENT EXPOSURE TO THE SAME MATERIAL. THEREFORE, THIS EVENT MEETS THE CRITERIA FOR REPORTABILITY PER 21 CFR PART 803. THE DEVICE WAS NOT RETURNED FOR EVALUATION AND THE LOT NUMBER WAS NOT PROVIDED FOR RETAINED-PRODUCT TESTING AND/OR DHR REVIEW.

Description of Event or Problem

IT WAS REPORTED THAT A PATIENT POSSIBLY HAD AN ALLERGIC REACTION TO THE USE OF IRM INTERMEDIATE RESTORATIVE MATERIAL.