FDA Adverse Event
Malfunction
Summary report: N
GUM BRAND TECHNIQUE DEEP CLEAN TOOTHBRUSH
MDR report key: 14349679
·
Received May 10, 2022
Report
- Report Number
- 0001413787-2022-00163
- Event Type
- Malfunction
- Date Received
- May 10, 2022
- Date of Event
- July 14, 2020
- Report Date
- July 14, 2020
- Manufacturer
- SUNSTAR AMERICAS INC.
- Product Code
- EFW
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 0
THIS MDR REPORT IS GENERATED RETROSPECTIVELY BASED ON COMPLAINTS AUDIT.
Description of Event or Problem · 0
CONSUMER WAS USING THE GUM TECHNIQUE DEEP CLEAN TOOTHBRUSH AND THE BRISTLES STARTED TO FALL OUT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 761718 | GUM BRAND TECHNIQUE DEEP CLEAN TOOTHBRUSH | TOOTHBRUSH, MANUAL | EFW | SUNSTAR AMERICAS INC. | 525D |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Female |