BEUDAMED
    FDA Adverse Event Injury Summary report: N

    TELEDYNE WATER PIK

    MDR report key: 149916 · Received February 13, 1998

    Report

    Report Number
    1712259-1998-00001
    Event Type
    Injury
    Date Received
    February 13, 1998
    Date of Event
    January 14, 1998
    Report Date
    February 13, 1998
    Manufacturer
    TELEDYNE WATER PIK
    Product Code
    JEQ
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AL, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    CONSUMER STATED THAT HE RECEIVED UNIT FOR CHRISTMAS AND USED IT EVERY DAY. HE FURTHER STATED THAT HE CHIPPED HIS TOOTH AND WENT TO THE DENTIST. THE DENTIST TOLD HIM THAT THE CHIPPED TOOTH WAS DUE TO THE SENSONIC UNIT, AND THAT HE WILL NEED A CROWN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TELEDYNE WATER PIK AUTOMATIC TOOTHBRUSH JEQ TELEDYNE WATER PIK SR-100W NA

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Required Intervention