inforMED
InjuryEBC

DELTON PIT & FISSURE SEALANT

Received Aug 17, 2004 · Event occurred Jul 1, 2004

Report 2515379-2004-00389 · MDR key 539561

Device

Generic name

Pit And Fissure Sealant And Conditioner

Model number

NA

Catalog number

27961

Lot number

UNK

Product problems

  • Device, removal of (non-implant)

Patient

12 YR

  • Allergic reaction
  • Hives

Narrative

Description of Event or Problem

A PT BROKE OUT IN HIVES AFTER HAVING FOUR DELTON SEALANTS PLACED INDICATING A POSSIBLE ALLERGIC REACTION. IT WAS REPORTED THAT THE PT WENT TO THE HOSP 3 TIMES, BUT NO INDICATION OF WHAT IF ANY TREATMENT WAS RENDERED. REMOVAL OF THE SEALANTS, HOWEVER, RELIEVED THE SYMPTOMS.