BEUDAMED
    FDA Adverse Event Other Summary report: N

    NA

    MDR report key: 931793 · Received October 21, 2007

    Report

    Report Number
    MW5004157
    Event Type
    Other
    Date Received
    October 21, 2007
    Date of Event
    September 9, 1999
    Report Date
    October 21, 2007
    Manufacturer
    NA
    Product Code
    EJJ
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CO, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    THE ABOVE DATE OF EVENT IS THE ACTUAL DATE THAT I WAS DIAGNOSED, AND I HAD OTHER SYMPTOMS THAT WERE PART OF THE DIAGNOSIS YEARS BEFORE THE ACTUAL DIAGNOSIS. IT WAS DURING SOME DENTAL WORK THAT I WAS HAVING DONE THAT THE MORE SEVERE SYMPTOMS STARTED TO FLARE UP. MY DENTIST RECOMMENDED THAT HAVE SOME OLD FILLINGS REPLACED AND AMALGAMS WERE COVERED ON MY DENTAL PLAN. I HAD A TOTAL OF 5 TEETH REFILLED WITH SILVER/AMALGAM ON THE LEFT SIDE OF MY MOUTH, IN 1998 AND 2 IN 1999. THE DENTIST WANTED TO CONTINUE TO THE RIGHT SIDE OF MY MOUTH WITH ANOTHER 4 FILLINGS. AT THAT TIME, I REFUSED AS IT WAS RIGHT AFTER MY DIAGNOSIS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 NA SILVER AMALGAM EJJ NA NA NA

    Patients

    Seq Age Sex Outcome Treatment
    1 33 YR Other