BEUDAMED
    FDA Adverse Event Injury Summary report: N

    DENTAL AMALGAM

    MDR report key: 5104011 · Received September 25, 2015

    Report

    Report Number
    MW5056431
    Event Type
    Injury
    Date Received
    September 25, 2015
    Date of Event
    September 1, 2015
    Report Date
    September 24, 2015
    Manufacturer
    UNKNOWN
    Product Code
    EJJ
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    (B)(4). CFS, FIBROMYALGIA, MS, LYME DISEASE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    635623 DENTAL AMALGAM EJJ UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 52.000 YR Hospitalization| S