inforMED
InjuryEIG

OPTIVIEW

Received Oct 18, 2019

Report 8031023-2019-00002 · MDR key 9206083

Device

Generic name

Lip And Cheek Retractor

Manufacturer

Kerr Hawe S.a

Catalog number

716-0050

Product problems

  • Appropriate Device Problem Term/Code Not Available
  • Appropriate Device Problem Term/Code Not Available

Patient

12 YR

  • No Code Available
  • No Code Available

Narrative

Additional Manufacturer Narrative

PATIENT EXPERIENCED SYMPTOMS OF PAIN, BURNING DISCOMFORT, SWOLLEN LIPS. PATIENT WAS RECOMMENDED TO THE EMERGENCY ROOM AND RECEIVED ORAL STEROID AS WELL AS ANTIHISTAMINE. AFTER ONE WEEK, SWELLING DISAPPEARED. SPECIFIC PATIENT INFORMATION WITH REGARDS TO ETHNICITY, RACE AND WEIGHT WAS NOT PROVIDED. NO LOT NUMBER WAS PROVIDED THEREFORE MANUFACTURE DATE CANNOT BE DETERMINED. THE PRODUCT WAS NOT RETURNED AND NO LOT NUMBER OR PART NUMBER WAS PROVIDED; THEREFORE, NO EVALUATION CAN BE CONDUCTED.

Description of Event or Problem

A COMPLAINANT ALLEGED THAT TWO (2) PATIENTS EXPERIENCED AN ALLERGIC REACTION RESULTING IN SWELLINGS, BURNING AND PAIN IN LIPS. THIS IS THE SECOND OF TWO REPORTS.