FDA Adverse Event Summary report: N

PERIOSHIELD

MDR report key: 12384772 · Received August 27, 2021

Report

Report Number
MW5103562
Date Received
August 27, 2021
Date of Event
June 15, 2021
Report Date
August 25, 2021
Product Code
NTO
Report Source
Voluntary report
Reporter Location
CA, US
Reporter Occupation
UNKNOWN

Narratives

Description of Event or Problem · 1

PRODUCT HAS BEEN RECALLED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1274979 PERIOSHIELD RINSE, ORAL, ANTIBACTERIAL (BY PHYSICAL MEANS) NTO 01A

Patients

Seq Age Sex Outcome Treatment
1 61 YR