inforMED
InjuryEGD

ELMEX WAX

Received Oct 11, 2007 · Event occurred Sep 11, 2007

Report 1036212-2007-00165 · MDR key 925632

Device

Generic name

Egd

Manufacturer

Dentsply Glenroe

Model number

NA

Catalog number

WB-ELMEX

Lot number

WO-094909

Product problems

  • Unknown (for use when the device problem is not known)

Patient

12 YR

  • Erythema
  • Hives
  • Irritation
  • Burning Sensation
  • Therapy/non-surgical treatment, aborted/stopped
  • Treatment with medication(s)

Narrative

Description of Event or Problem

IT WAS REPORTED THAT A PATIENT DEVELOPED REDDENING, BURNING, IRRITATION, AND LARGE HIVES ON THE GINGIVAL TISSUE AND BACK, EYES, AND STOMACH WITHIN A FEW HRS OF USING ELMEX WAX. THE PT DISCONTINUED USE AND CONSULTED A PHYSICIAN WHO ADMINISTERED SOLUPRED (CORTISONE) AND VIZAL (AN ANTIHISTAMINE). ALSO, THE PHYSICIAN TESTED THE PT FOR FOOD ALLERGIES WITH NEGATIVE RESULTS; FURTHER ALLERGY TESTS ARE PLANNED, THOUGH RESULTS ARE NOT AVAILABLE AS OF THIS REPORT.

Additional Manufacturer Narrative

WHILE IT IS UNKNOWN, IF THE WAX USED IN THIS CASE CAUSED OR CONTRIBUTED TO THE PT'S SYMPTOMS, IT IS POSSIBLE AS ALLERGIC REACTIONS TO DENTAL MATERIALS ARE KNOWN AND REPORTED, WITH MEDICAL CONSEQUENCES BEING DEPENDENT UPON THE SEVERITY OF THE INDIVIDUAL ALLERGIC RESPONSE AND SUBSEQUENT EXPOSURE TO THE SAME MATERIAL. FURTHER, A STEROID AND AN ANTIHISTAMINE WERE ADMINISTERED AS A RESULT. THEREFORE, THIS EVENT IS REPORTABLE PER 21 CFR PART 803. A DHR REVIEW CONDUCTED INDICATES THAT THE PRODUCT WAS MANUFACTURED ACCORDING TO SPECIFICATIONS. ALSO, THE SUPPLIER NOTED THAT THE WAX IS DERIVED ENTIRELY FROM PETROLEUM HYDROCARBONS AND DOES NOT CONTAIN ANY ALLERGENS.