UNK

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2000-09-05 for UNK manufactured by Unk.

Event Text Entries

[187507] Began experiencing numbness and pain below a tooth in which rptr had a root canal done in a number of years ago. The numbness radiated out to complete jaw area, lips, and tongue. An endodontist attempted a retreatment of the tooth which was unsuccessful and tooth was extracted. Numbness increased to jaw areas. Numbness still persists after 5 months. This writer feels unsafe endodontic materials were used and these materials leeched into blood stream after tooth deteriorated causing parethesia and pain.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW1019888
MDR Report Key295744
Date Received2000-09-05
Date of Report2000-08-28
Date of Event2000-03-27
Date Added to Maude2000-09-15
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Reporter OccupationPATIENT
Health Professional3
Initial Report to FDA0
Report to FDA0
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameNA
Generic NameNA
Product CodeEKK
Date Received2000-09-05
Model NumberUNK
Catalog NumberUNK
Lot NumberUNK
ID NumberUNK
Device Availability*
Implant FlagN
Date RemovedA
Device Sequence No1
Device Event Key286265
ManufacturerUNK
Manufacturer AddressUNK UNK *


Patients

Patient NumberTreatmentOutcomeDate
101. Deathisabilit 2000-09-05

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