BEUDAMED
    FDA Adverse Event Other Summary report: N

    SONICARE

    MDR report key: 2872364 · Received December 5, 2012

    Report

    Report Number
    3026630-2012-00020
    Event Type
    Other
    Date Received
    December 5, 2012
    Date of Event
    November 6, 2012
    Report Date
    December 5, 2012
    Manufacturer
    PHILIPS ORAL HEALTHCARE
    Product Code
    JEQ
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    LA, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    ON (B)(6) 2012, CONSUMER STATED THAT HE IS HAVING A CAP PUT ON HIS DAMAGED TOOTH. CONSUMER STATES THAT THE TOOTH HAD PREVIOUS WORK DONE ON IT, A FILLING, HOWEVER, WOULD NOT STATE HOW OLD HIS FILLING WAS. ON (B)(4) 2012, WILL FILE A FOLLOW UP WHEN FAILURE ANALYSIS IS COMPLETED.

    Description of Event or Problem · 1

    ON (B)(6) 2012, CONSUMER STATED THAT THEY CHIPPED THEIR TOOTH.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SONICARE HEALTHYWHITE JEQ PHILIPS ORAL HEALTHCARE HX6711

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK Other