FDA Adverse Event Other Summary report: N

FIXODENT DENTURE ADHESIVE, VERSION UNK (CALCIUM ZINC GANTREZ SALT 33% CELLULOSE

MDR report key: 1651934 · Received April 5, 2010

Report

Report Number
1530449-2010-00016
Event Type
Other
Date Received
April 5, 2010
Report Date
February 18, 2010
Manufacturer
PROCTER & GAMBLE MANUFACTURIN CO.
Product Code
KOO
PMA / PMN Number
(US)OTC DEVI
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

LOT NUMBER OR PRODUCT WAS NOT PROVIDED BY THE REPORTER THEREFORE UNABLE TO PROCEED WITH BATCH RETAIN TESTING OR PRODUCT INVESTIGATION. PMA/510(K)# 945200.

Description of Event or Problem · 1

EVENT VERBATIM [PREFERRED TERM] (RELATED SYMPTOMS IF ANY SEPARATED BY COMMAS). PROFOUND AND PERMANENT NEUROLOGICAL INJURIES [NERVOUS SYSTEM DISORDER]. NEUROPATHY [NEUROPATHY PERIPHERAL], EXCESS ZINC [BLOOD ZINC INCREASED], COPPER DEPLETION [BLOOD COPPER DECREASED], OTHER PROFOUND AND PERMANENT INJURIES, PHYSICAL INJURIES [INJURY]. CASE DESCRIPTION: AN ATTORNEY REPORTED THAT THEIR CLIENT, A MALE AGE (B)(6), USED FIXODENT DENTURE ADHESIVE, VERSION UNK CREAM AND SUPER POLIGRIP, AS DENTURE ADHESIVE PRODUCTS OF CHOICE, AND REPORTED THE FOLLOWING: NEUROPATHY DIAGNOSED IN 2008; DIAGNOSED WITH EXCESS ZINC AND COPPER DEPLETION; PROFOUND AND PERMANENT NEUROLOGICAL INJURIES; OTHER PROFOUND AND PERMANENT INJURIES; PHYSICAL INJURIES WHICH HAVE LEFT HIM UNABLE TO PERFORM HIS NORMAL, CUSTOMARY AND DAILY ACTIVITIES. HE HAS RECEIVED AND WILL CONTINUE TO RECEIVE UNSPECIFIED MEDICAL CARE AND TREATMENT. THE CASE OUTCOME WAS NOT RECOVERED/NOT RESOLVED. PAST MEDICAL HISTORY INCLUDED: MEDICAL HISTORY - DENTURE WEARER. NO FURTHER INFO WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FIXODENT DENTURE ADHESIVE, VERSION UNK (CALCIUM ZINC GANTREZ SALT 33% CELLULOSE DENTURE ADHESIVE KOO PROCTER & GAMBLE MANUFACTURIN CO.

Patients

Seq Age Sex Outcome Treatment
1 46 YR Disability