inforMED
InjuryDZB

PROTRACTION FACEMASK

Received Feb 26, 2013

Report 2418500-2013-00001 · MDR key 2987613

Device

Manufacturer

Gac International

Catalog number

17-100-20

Lot number

0711

Product problems

  • Insufficient Device Problem Information

Patient

Not reported

  • Hypersensitivity/Allergic reaction

Narrative

Description of Event or Problem

IN THIS EVENT IT WAS REPORTED THAT THE PT EXPERIENCED AN ALLERGIC REACTION TO THE PROTRATION FACEMASK ON THEIR CHIN. NO MEDICAL ATTENTION WAS NECESSARY AND THE AFFECTED CLEARED UP WITH IN 24 HOURS.

Additional Manufacturer Narrative

WHILE IT IS UNK IF THE DEVICE USED IN THIS CASE CAUSED OR CONTRIBUTED TO THE PT'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 IS AVAILABLE FOR EVALUATION, THOUGH RESULTS ARE NOT AVAILABLE AS OF THIS REPORT. EVALUATION RESULTS WILL BE SUBMITTED AS THEY BECOME AVAILABLE.