inforMED
InjuryEJJ

TYTIN

Received Jun 8, 2018 · Event occurred Sep 1, 2015

Report 1815757-2018-00004 · MDR key 7584843

Device

Generic name

Dental Amalgam Capsule

Manufacturer

Kerr Corporation

Catalog number

29949

Lot number

5-1092

Product problems

  • Device Operates Differently Than Expected

Patient

Not reported

  • No Code Available
  • No Code Available

Narrative

Additional Manufacturer Narrative

NO PATIENT INFORMATION IN REGARDS TO AGE, WEIGHT, ETHNICITY, AND RACE WAS PROVIDED. THE DATE OF EVENT IS ESTIMATED BECAUSE THE EXACT DAY WAS NOT PROVIDED. AN EVALUATION OF THE PRODUCT IS EXPECTED BUT HAS NOT YET BEGUN.

Description of Event or Problem

AN ALLEGED COMPLAINT WAS REPORTED THAT A PATIENT WAS EXPERIENCING PAIN AND THE DOCTOR HAD TO REMOVE THE AMALGAM. IT WAS NOTED THAT TH BOTTOM OF THE AMALGAM LOOKED LIKE "GRAVEL" AS IF IT HAS NEVER SET. THE AMALGAM WAS PLACED (B)(6) 2011 THE PATIENT'S TOOTH HAD TO BE EXTRACTED. NO ADDITIONAL INJURIES OR MEDICAL INTERVENTION WAS NOTED.