BEUDAMED
    FDA Adverse Event Injury Summary report: N

    GUTTA PERCHA

    MDR report key: 194715 · Received October 23, 1998

    Report

    Report Number
    MW1014860
    Event Type
    Injury
    Date Received
    October 23, 1998
    Date of Event
    October 8, 1998
    Report Date
    October 19, 1998
    Manufacturer
    UNK
    Product Code
    EKM
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    KS, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    GUTTA PERCHA PLACED ON 10/8/98, INCREASED ASTHMA ON 10/9/98, PREVENTIL HFA, AROBIOM TILADE. GREATER INCREASED ASTHMA ON 10/10/98, PEAK FLOW 350 (NORMAL 600). ASTHMA, HIVES AT 2 AM ON 10/11/98, PEAK FLOW 350, PROVENTIL HFA, BENADRYL IM 50MG, PREDNISONE 20MG BY MOUTH. PREDNISONE TAPERING DOSES FROM 10/11-10/18/98: 60MG, 60MG, 40MG, 40MG, 20MG, 20MG, 10MG, 10MG. CONTINUED PROVENTIL HFA AS NEEDED. GUTTA PERCHA REMOVED ON 10/13/98. SINGNIFICANT EASING OF ASTHMA ON 10/15/98. NO SYMPTOMS ON 10/16/98.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 GUTTA PERCHA GUTTA PERCHA EKM UNK * *

    Patients

    Seq Age Sex Outcome Treatment
    1 50 YR Life Threatening