AMALGAM SILVER FILLINGS

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2011-09-19 for AMALGAM SILVER FILLINGS manufactured by Unk.

Event Text Entries

[2279748] I had amalgam silver fillings inserted in my mouth at age (b)(6). In the fillings (they contained large amounts of toxic mercury) which later resulted in cancer, according to many physicians.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5022507
MDR Report Key2281589
Date Received2011-09-19
Date of Report2011-09-19
Date of Event1950-01-01
Date Added to Maude2011-10-11
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationPATIENT
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameAMALGAM SILVER FILLINGS
Generic NameNONE
Product CodeEJJ
Date Received2011-09-19
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Sequence No1
Device Event Key0
ManufacturerUNK
Manufacturer AddressUNK UNK


Patients

Patient NumberTreatmentOutcomeDate
101. Hospitalization; 2. Life Threatening; 3. Other; 4. Required No Informationntervention 2011-09-19

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