MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-03-13 for DENTAL AMALGAM manufactured by Unknown.
[69797330]
(b)(4). I had a large amalgam filling replaced.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | MW5068420 |
| MDR Report Key | 6399466 |
| Date Received | 2017-03-13 |
| Date of Report | 2017-01-08 |
| Date of Event | 2017-01-03 |
| Date Added to Maude | 2017-03-13 |
| Event Key | 0 |
| Report Source Code | Voluntary report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | PATIENT |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | DENTAL AMALGAM |
| Product Code | EKH |
| Date Received | 2017-03-13 |
| Device Availability | * |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | UNKNOWN |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Life Threatening; 2. Required No Informationntervention; 3. Deathisabilit | 2017-03-13 |