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MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2005-08-03 for * manufactured by *.

Event Text Entries

[497625] I had metal braces from 1990-1993. The orthodontist moved the teeth too fast causing me to lose my 4 front teeth. Some dentists have told me that i will lose the other 4 front teeth. The orthodontist and all subsequent dentists cancealed from me the damage to my bones and bite until the teeth began to fall out. I have two sets of bridges made but the first was below standard and the second set is still needing adjustments.
Patient Sequence No: 1, Text Type: D, B5

MAUDE Entry Details

• Report Number: MW1036225
• MDR Report Key: 751577
• Date Received: 2005-08-03
• Date of Report: 2005-08-02
• Date of Event: 1993-01-01
• Date Added to Maude: 2006-08-18
• 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: 0
• Previous Use Code: 0
• Event Type: 3
• Type of Report: 3

Device Details

• Brand Name: *
• Generic Name: METAL DENTAL ORTHODONTIC BRACES
• Product Code: NQS
• Date Received: 2005-08-03
• Model Number: *
• Catalog Number: *
• Lot Number: *
• ID Number: *
• Operator: HEALTH PROFESSIONAL
• Device Availability: N
• Device Age: *
• Implant Flag: Y
• Date Removed: *
• Device Sequence No: 1
• Device Event Key: 739390
• Manufacturer: *
• Manufacturer Address: * * *

Patients

Patient Number	Treatment	Outcome	Date
1	0	1. Other; 2. Deathisabilit	2005-08-03