BEUDAMED
    FDA Adverse Event Injury Summary report: N

    SUPER POLIGRIP

    MDR report key: 1845023 · Received September 22, 2010

    Report

    Report Number
    MW5017574
    Event Type
    Injury
    Date Received
    September 22, 2010
    Date of Event
    March 7, 2007
    Report Date
    September 22, 2010
    Manufacturer
    UNK
    Product Code
    KOL
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    TINGLING IN TOES. FREQUENCY: LESS THAN DAILY, ROUTE: PO. DATES OF USE: (B)(6)1997 - (B)(6)2010 DIAGNOSIS OR REASON FOR USE: DENTURES. EVENT ABATED AFTER USE: NO.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SUPER POLIGRIP DENTURE CREAM KOL UNK UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 57 YR Required Intervention