Brand Name | ORALBPWRRCHGTOOTHBRUSHHANDLE3765GENIUS |
Type of Device | TOOTHBRUSH, POWERED |
Manufacturer (Section D) |
BRAUN GMBH WERK MARKTHEIDENFELD |
40 baumhofstrasse |
marktheidenfeld, D-978 28 |
GM D-97828 |
|
Manufacturer (Section G) |
BRAUN GMBH WERK MARKTHEIDENFELD |
40 baumhofstrasse |
|
marktheidenfeld, D-978 28 |
GM
D-97828
|
|
Manufacturer Contact |
regulatory
oral care
|
8700 mason-montgomery rd |
mason, OH 45040
|
|
MDR Report Key | 12738465 |
MDR Text Key | 281094866 |
Report Number | 3000302531-2021-00349 |
Device Sequence Number | 1 |
Product Code |
JEQ
|
Combination Product (y/n) | N |
Reporter Country Code | GM |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Foreign,Consumer |
Reporter Occupation |
Other
|
Type of Report
| Initial,Followup |
Report Date |
10/04/2021 |
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 Model Number | 3765 |
Device Lot Number | BC801111636 |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 08/28/2021 |
Initial Date Manufacturer Received |
Not provided
|
Initial Date FDA Received | 11/02/2021 |
Supplement Dates Manufacturer Received | Not provided
|
Supplement Dates FDA Received | 11/12/2021
|
Was Device Evaluated by Manufacturer? |
Yes
|
Is the Device Single Use? |
No
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Unknown
|
Patient Sequence Number | 1 |
Treatment | ORAL-B BRUSHHEADS, VERSION UNKNOWN |
Patient Sex | Male |
|
|