MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-11-22 for DENTAL AMALGAM FILLINGS manufactured by Unk.
| Report Number | MW5091279 |
| MDR Report Key | 9369095 |
| Date Received | 2019-11-22 |
| Date of Report | 2019-11-21 |
| Date of Event | 2014-07-01 |
| Date Added to Maude | 2019-11-25 |
| 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 | 0 |
| Brand Name | DENTAL AMALGAM FILLINGS |
| Generic Name | ALLOY, AMALGAM |
| Product Code | EJJ |
| Date Received | 2019-11-22 |
| Device Availability | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | UNK |
| Manufacturer Address | UNK UNK |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-11-22 |