inforMED
InjuryELM

MONDIAL

Received Sep 25, 2017

Report 3006610834-2017-00001 · MDR key 6891932

Device

Generic name

Denture, Plastic, Teeth

Manufacturer

Kulzer Gmbh

Catalog number

66016910

Product problems

  • Adverse Event Without Identified Device or Use Problem
  • Adverse Event Without Identified Device or Use Problem

Patient

Not reported

  • Complaint, Ill-Defined
  • Complaint, Ill-Defined

Narrative

Additional Manufacturer Narrative

AS ALLOWED BY EXEMPTION #E2013019, KULZER, LLC (THE IMPORTER) IS REPORTING ON BEHALF OF KULZER, GMBH (THE MANUFACTURER). ALTHOUGH WE HAVE NOT ESTABLISHED THE DEVICE CAUSED OR CONTRIBUTED TO THE EVENT, THE INCIDENT WILL BE REPORTED TO MAINTAIN COMPLIANCE WITH 21 CFR 803 AND OUT OF AN ABUNDANCE OF CAUTION.

Description of Event or Problem

PATIENT COMPLAINS OF VAGUE ALLERGY SYMPTOMS.