inforMED
InjuryEJK

ULTRADENT ULTRACAL XS CALCIUM HYDROXIDE PASTE

Received Oct 17, 2019 · Event occurred May 29, 2019

Report MW5090472 · MDR key 9208114

Device

Generic name

Liner, Cavity / Calcium Hydroxide

Product problems

  • Improper or Incorrect Procedure or Method

Patient

40 YR

  • No Code Available
  • No Code Available

Narrative

Description of Event or Problem

ON (B)(6) 2019, MY ENDODONTIST OVERFILLED THE ROOT CANAL OF TOOTH #19 WITH CALCIUM HYDROXIDE RESULTING IN PERSISTENT ANESTHESIA AND DYSESTHESIA. ON (B)(6) 2019, (B)(6), DDS, MD SURGICALLY REMOVED PORTIONS OF THE CALCIUM HYDROXIDE OVERFILL WHICH HAD MUMMIFIED MY MANDIBULAR NERVE; TREATMENT RECORDS OF THE FOLLOWING: RECORDS-AND (B)(6) 2019 PANOREX X-RAY OF ENDODONTIST, (B)(6), DDS, MD'S SURGICAL REPORT, (B)(6) CBCT DATED (B)(6) 2019, TREATMENT RECORD OF THE ENDODONTIST'S CALCIUM HYDROXIDE OVERFILL INCLUDING RADIOGRAPH DATED (B)(6) 2019, SURGICAL RECORD OF DR (B)(6). NO MEDICATIONS FOR PERSISTENT ANESTHESIA OF MY LEFT LIP, CHIN, AND GUMS.