BEUDAMED
    FDA Adverse Event Injury Summary report: N

    DENTAL AMALGAM

    MDR report key: 6399466 · Received March 13, 2017

    Report

    Report Number
    MW5068420
    Event Type
    Injury
    Date Received
    March 13, 2017
    Date of Event
    January 3, 2017
    Report Date
    January 8, 2017
    Manufacturer
    UNKNOWN
    Product Code
    EKH
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    (B)(4). I HAD A LARGE AMALGAM FILLING REPLACED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    182497 DENTAL AMALGAM EKH UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 47.000 YR Life Threatening| R| S