inforMED
InjuryEMA

MAXCEM ELITE

Received Aug 18, 2014

Report 2024312-2014-00587 · MDR key 4017428

Device

Generic name

Cement, Dental

Manufacturer

Kerr Corporation

Catalog number

33872

Product problems

  • Loss of or Failure to Bond
  • Material Integrity Problem

Patient

82 YR

  • No Code Available

Narrative

Additional Manufacturer Narrative

THE OFFICE DID NOT PROVIDE ANY SPECIFIC INFORMATION REGARDING THE MAXCEM ELITE WHICH HAD BEEN USED ON THE PATIENT; THEREFORE, NO LOT NUMBER OR EXPIRATION DATE WAS IDENTIFIED IN THIS REPORT. THE DOCTOR REPORTED THAT IN (B)(6) 2014, THE BRIDGE HAD DEBONDED DURING A ROOT CANAL PROCEDURE WHICH WAS BEING COMPLETED THROUGH THE RESTORATION. THE PATIENT RETURNED IN (B)(6) 2014 FOR RE-CEMENTATION OF THE BRIDGE. THE DOCTOR RE-CEMENTED THE RESTORATION USING A DIFFERENT PRODUCT, WITHOUT FURTHER INCIDENT. TO DATE, THE PATIENT IS DOING FINE. THE PRODUCT INVOLVED IN THE ALLEGED INCIDENT WAS NOT RETURNED AND NO LOT NUMBER WAS PROVIDED; THEREFORE, NO EVALUATION CAN BE CONDUCTED.

Description of Event or Problem

A DOCTOR ALLEGED THAT A PATIENT HAD EXPERIENCED THE DEBONDING OF A BRIDGE THAT HAD BEEN CEMENTED WITH MAXCEM ELITE.