BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNKNOWN

    MDR report key: 1060673 · Received June 12, 2008

    Report

    Report Number
    MW5007291
    Event Type
    Injury
    Date Received
    June 12, 2008
    Date of Event
    October 20, 1958
    Report Date
    June 12, 2008
    Manufacturer
    UNKNOWN
    Product Code
    EJJ
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    FL, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    I HAD SILVER FILLINGS PLACED IN MY MOUTH WHEN I WAS ABOUT 50 YEARS AGO. NOW, I AM HAVING ONLY 1 KIDNEY, I MAY HAVE HAD DAMAGE DONE TO THE ONLY KIDNEY I HAVE TO KEEP ME ALIVE AND NEVER WAS AWARE OF IT UNTIL NOW. DIAGNOSIS OR REASON FOR USER: FILLINGS FOR CAVITIES.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 UNKNOWN SILVER TEETH FILLINGS EJJ UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 12 YR Life Threatening| R