GLUMA DESENSITIZER 65872354

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-05-21 for GLUMA DESENSITIZER 65872354 manufactured by Kulzer, Gmbh.

Event Text Entries

[145634661] This material is known to be caustic to soft tissue. Our dfu states "to protect mucous membranes by using a rubber dam. Make sure that gluma desensitizer only comes into contact with the area to be treated " and " it is a local irritant and has toxic effects. Appropriate precautions should always be taken before using gluma desensitizer". Per the patient, there was no rubber dam used prior to the initial application of this product. Follow up calls to patient determined that the healing process is still occuring and she is under treatment with pcp.
Patient Sequence No: 1, Text Type: N, H10


[145634662] Patient was seen in office for anterior veneers. After the prep, gluma was placed by the dental assistant prior to having the temporary crowns placed. Pt immediately began feeling a burning sensation and notified the dental assistant. There was no rubber dam or barrier protection placed prior to the gluma desensitizer. Patient was told to spit out the product and was given water to rinse out with. The dr then returned to the room and "painted on" the gluma and seated the temporaries. Patient was seen at the er the day after with complaints of a burning sensation and irritation on her lips and gums. Patient was also seen by her primary medical dr for the same concerns. Patient was prescribed ibuprofen, prednisone and some mouthwash ((b)(6) mouthwash).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1821514-2019-00005
MDR Report Key8627603
Date Received2019-05-21
Date of Report2019-05-20
Date of Event2019-04-29
Date Facility Aware2019-05-02
Report Date2019-05-02
Date Reported to Mfgr2019-05-02
Date Added to Maude2019-05-21
Event Key0
Report Source CodeDistributor report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameGLUMA DESENSITIZER
Generic NameDESENSITIZING AGENT
Product CodeKLE
Date Received2019-05-21
Catalog Number65872354
Lot NumberUNKNOWN
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerKULZER, GMBH
Manufacturer AddressPHILIPP-REIS-STRABE 8/13 WEHRHEIM, D-61273 GM D-61273


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2019-05-21

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