FDA Adverse Event
Injury
Summary report: N
VENUS COMPOSITE
MDR report key: 3447130
·
Received October 1, 2013
Report
- Report Number
- 9610902-2013-00101
- Event Type
- Injury
- Date Received
- October 1, 2013
- Manufacturer
- HERAEUS KULZER GMBH & CO. KG, MEDICAL DIVISION
- Product Code
- EBF
- PMA / PMN Number
- K020131
- Report Source
- Manufacturer report
Narratives
Additional Manufacturer Narrative · 1
(B)(4). ALTHOUGH 608, WE'RE REPORTING IT TO BE COMPLIANT WITH 21 CFR PART 803 AND OUT OF AN ABUNDANCE OF CAUTION. ALLERGIC REACTIONS TO DENTAL MATERIALS ARE KNOWN AND DOCUMENTED. THE DIRECTIONS FOR USE STATES, "DO NOT USE VENUS IN PATIENTS, WHICH ARE ALLERGIC AGAINST THE INGREDIENTS OF VENUS."
Description of Event or Problem · 1
(B)(4).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 495602 | VENUS COMPOSITE | EBF, MATERIAL, TOOTH SHADE, RESIN | EBF | HERAEUS KULZER GMBH & CO. KG, MEDICAL DIVISION |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |