Brand Name | ORAL-B BRUSHHEADS, VERSION UNKNOWN |
Type of Device | TOOTHBRUSH, POWERED |
Manufacturer (Section D) |
BRAUN GMBH WERK MARKTHEIDENFELD |
40 baumhofstrasse |
marktheidenfeld, D-978 28 |
GM D-97828 |
|
MDR Report Key | 11769224 |
MDR Text Key | 251239928 |
Report Number | 3000302531-2021-00164 |
Device Sequence Number | 1 |
Product Code |
JEQ
|
Combination Product (y/n) | N |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
consumer,foreign |
Type of Report
| Initial,Followup |
Report Date |
04/13/2021 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Lay User/Patient
|
Device Lot Number | NOT AVAILABLE |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 06/01/2021 |
Initial Date Manufacturer Received |
04/13/2021 |
Initial Date FDA Received | 05/04/2021 |
Supplement Dates Manufacturer Received | 06/04/2021
|
Supplement Dates FDA Received | 06/09/2021
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Patient Sequence Number | 1 |
Treatment | ORAL-B RECHARGEABLE TOOTHBRUSH, VERSION UNKNOWN; ORAL-B RECHARGEABLE TOOTHBRUSH, VERSION UNKNOWN |
Patient Age | 63 YR |
|
|