BEUDAMED
    FDA Adverse Event Injury Summary report: N

    DENTAL AMALGAM

    MDR report key: 1685978 · Received May 7, 2010

    Report

    Report Number
    MW5015884
    Event Type
    Injury
    Date Received
    May 7, 2010
    Date of Event
    June 3, 1986
    Report Date
    May 7, 2010
    Product Code
    EJJ
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    EI
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    AMALGAM FILLING PUT IN 4 TEETH BY DENTAL SURGEON, RESULTING IN BELLS PALSY, BALANCE PROBLEMS, SEVERE HEADACHES, NUMBNESS IN ARMS AND FEET, NERVE PAINS ALLOVER THE BODY, NIGHT VISION LOSS, FATIGUE, NIGHT SWEATS. DOSE OR AMOUNT: 4 FILLINGS, ROUTE: DENTAL. DATES OF USE: (B) (6) 1986 - (B) (6) 2004. DIAGNOSIS OR REASON FOR USE: DENTAL CAVITIES. EVENT ABATED AFTER USE: YES.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DENTAL AMALGAM DENTAL FILLINGS EJJ

    Patients

    Seq Age Sex Outcome Treatment
    1 40 YR Hospitalization| R| S