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