| Brand Name | GUM TECHNIQUE DEEP CLEAN COMPACT/SOFT, 3PACK |
| Common Device Name | MANUAL TOOTHBRUSH |
| Manufacturer (Section D) |
| SUNSTAR AMERICAS, INC |
| 301 e. central road |
| schaumburg IL 60195 |
|
| Manufacturer (Section G) |
| SUNSTAR AMERICAS, INC |
| 301 e. central road |
|
| schaumburg IL 60195 |
|
| Manufacturer Contact |
|
priya
bhatia
|
| 301 e. central road |
| schaumburg, IL 60195
|
|
8477944331
|
|
| MDR Report Key | 23537859 |
| Report Number | 1413787-2025-00242 |
| Device Sequence Number | 21103180 |
| Product Code |
EFW
|
| UDI-Device Identifier | 00070942008112 |
| UDI-Public | 00070942008112 |
| Combination Product (Y/N) | N |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Consumer |
| Initial Reporter Occupation |
Other
|
| Type of Report
| Initial |
| Report Date (Section B) |
11/12/2025 |
| 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 Model Number | 525LT |
| Was Device Available for Evaluation? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 10/15/2025 |
| Initial Report FDA Received Date | 11/12/2025 |
| Usage of Device |
A
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |
|
|