inforMED
InjuryEMA

IRM ZOE INTERMEDIATE RESTORATIVE MATERIAL

Received Jun 18, 2015 · Event occurred May 11, 2015

Report 8010638-2015-00006 · MDR key 4860145

Device

Generic name

Dental Cement

Manufacturer

Dentsply Caulk

Catalog number

60661500

Lot number

1307000087

Product problems

  • Patient-Device Incompatibility
  • Insufficient Device Problem Information

Patient

Not reported

  • Dyspnea
  • Hypersensitivity/Allergic reaction
  • Complaint, Ill-Defined
  • Reaction

Narrative

Additional Manufacturer Narrative

MULTIPLE UNSUCCESSFUL ATTEMPTS WERE MADE TO OBTAIN THE DEVICE FOR EVALUATION. RETAIN PRODUCT WAS TESTED AND FOUND TO BE WITHIN SPECIFICATION.

Description of Event or Problem

IN THIS EVENT IT WAS REPORTED THAT A PATIENT EXPERIENCED AN ALLERGIC REACTION AFTER THE USE OF IRM CEMENT. THE PATIENT DEVELOPED A COUGH, WHICH WORSENED AND THEN HAD DIFFICULTY BREATHING. THE PATIENT SAW HER DOCTOR WHO PRESCRIBED AN ANTIHISTAMINIC DRUG. THE PATIENT HAS SINCE RECOVERED.

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 IS AVAILABLE FOR EVALUATION, THOUGH RESULTS ARE NOT AVAILABLE AS OF THIS REPORT. EVALUATION RESULTS WILL BE SUBMITTED AS THEY BECOME AVAILABLE.