BEUDAMED
    FDA Adverse Event Injury Summary report: N

    DISPERSALLOY

    MDR report key: 1686073 · Received May 8, 2010

    Report

    Report Number
    MW5015921
    Event Type
    Injury
    Date Received
    May 8, 2010
    Date of Event
    April 1, 2010
    Report Date
    May 8, 2010
    Manufacturer
    DENTSPLY INTERNATIONAL
    Product Code
    EJJ
    Report Source
    Voluntary report
    Reporter Location
    NJ, US
    Reporter Occupation
    DENTIST

    Narratives

    Description of Event or Problem · 1

    THE PATIENT HAD A LARGE MERCURY FILLING PLACED BY ANOTHER DENTIST AND ALMOST IMMEDIATELY WENT INTO A BOUT OF INEXPLICABLE DEPRESSION, AND TREMORS IN HIS HANDS. FORTUNATELY, HIS COMMON SENSE PREVAILED, AND HE LOOKED TOWARDS WHAT CHANGES HAD OCCURRED IN HIS LIFE PRIOR TO THIS EVENT. HE LOOKED TOWARDS THE MERCURY FILLING AS A CAUSE, AND SOUGHT ME OUT TO REMEDIATE THE MERCURY TOXIC EVENT. USING THE CORRECT PROTOCOL FOR REMOVAL, AND WITH CHELATION OF BODY MERCURY WITH A HOLISTIC MD, THE SYMPTOMS ALMOST IMMEDIATELY WERE REVERSED. DATES OF USE: 3 WEEKS (B) (6) 2010 -- (B) (6) 2010. DIAGNOSIS OR REASON FOR USE: DECAY OF TEETH. EVENT ABATED AFTER USE STOPPED OR DOSE REDUCED?: YES.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DISPERSALLOY MERCURY FILLING MATERIAL EJJ DENTSPLY INTERNATIONAL 93993-10
    2 DISPERSALLOY MERCURY FILLING MATERIAL EJJ DENTSPLY INTERNATIONAL 9696969

    Patients

    Seq Age Sex Outcome Treatment
    1 59 YR Disability DISPERSALLOY