BEUDAMED
    FDA Adverse Event Other Summary report: N

    SUPER POLIGRIP

    MDR report key: 1943965 · Received December 27, 2010

    Report

    Report Number
    MW5018733
    Event Type
    Other
    Date Received
    December 27, 2010
    Date of Event
    March 5, 2010
    Report Date
    December 27, 2010
    Manufacturer
    GLAXOSMITHKLINE
    Product Code
    KOP
    Report Source
    Voluntary report
    Reporter Location
    ME, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    NUMBNESS AND TINGLING WITH BALANCE PROBLEMS AND THE LOSS OF SENSATION AND UNEXPLAINED PAIN AND ISSUES WALKING, THE PRIMARY PHYSICIAN THOUGHT I HAD A STROKE AND SENT ME TO NEUROLOGIST. DENTURE REALIGNED EVERY 2 YEARS BY DR YEATON AS INSURANCE WOULD ALLOW. DOSE OR AMOUNT: UPPER AND LOWER, FREQUENCY: AS NEEDED, ROUTE: DENTAL. DATES OF USE: (B)(6) 2010. DIAGNOSIS OR REASON FOR USE: TO HOLD DENTURES ON THE ADVICE OF DENTIST.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SUPER POLIGRIP DENTURE CREAM KOP GLAXOSMITHKLINE SUPER STRONG ALL

    Patients

    Seq Age Sex Outcome Treatment
    1 69 YR