BEUDAMED
    FDA Adverse Event Injury Summary report: N

    QUIK-FIX

    MDR report key: 10452 · Received December 10, 1993

    Report

    Report Number
    MW1000066
    Event Type
    Injury
    Date Received
    December 10, 1993
    Date of Event
    September 8, 1993
    Report Date
    October 19, 1993
    Manufacturer
    PERTUSSIN LABORATORIES DIV. BRIMMS
    Product Code
    EBO
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MA, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    DEVELOPMENT OF MUCOEPIDERMOID CARCINOMA HARD PALATE DIRECTLY BENEATH HOME-REPAIR OF MAXILLARY DENTURE SEVERAL MONTHS PREVIOUSLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 QUIK-FIX HOME DENTURE REPAIR KIT EBO PERTUSSIN LABORATORIES DIV. BRIMMS

    Patients

    Seq Age Sex Outcome Treatment
    1 73 YR Not Applicable| H| L