BEUDAMED
    FDA Adverse Event Summary report: N

    GREEN 6 X 6 EXTRA HEAVY RUBBER DENTAL DAM

    MDR report key: 11315 · Received February 1, 1994

    Report

    Report Number
    MW4000168
    Date Received
    February 1, 1994
    Date of Event
    June 4, 1993
    Report Date
    July 12, 1993
    Manufacturer
    HYGENIC CORP.
    Product Code
    EIE
    Report Source
    Voluntary report
    Reporter Location
    AK, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    ALLERGIC REACTION/CONTACT DERMATITIS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 GREEN 6 X 6 EXTRA HEAVY RUBBER DENTAL DAM EIE HYGENIC CORP.

    Patients

    Seq Age Sex Outcome Treatment
    1 9 YR