WATERPIK WATER FLOSSER WP-72

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-01-20 for WATERPIK WATER FLOSSER WP-72 manufactured by Water Pik, Inc..

Event Text Entries

[36467212] Unit in question has not yet been returned for testing and evaluation.
Patient Sequence No: 1, Text Type: N, H10


[36467213] Per the customer.... Use at lowest pressure setting loosened/removed a bridge.
Patient Sequence No: 1, Text Type: D, B5


[38866502] Returned product was pressure tested at low, high and each of the four detent settings. All pressures were within normal range for this product. At the lowest setting the pressure was only 16 psi. Customer claimed this loosened her teeth and bridge, this is too low a pressure to cause any damage.
Patient Sequence No: 1, Text Type: N, H10


[38866503] Per the customer.... Use at lowest pressure setting loosened/removed a bridge.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0001712259-2016-00001
MDR Report Key5381622
Date Received2016-01-20
Date of Report2016-02-08
Date of Event2016-01-19
Date Mfgr Received2016-01-19
Device Manufacturer Date2014-03-10
Date Added to Maude2016-01-20
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. ROBERT VANDER VLIET
Manufacturer Street1730 EAST PROSPECT ROAD
Manufacturer CityFORT COLLINS CO 805530001
Manufacturer CountryUS
Manufacturer Postal805530001
Manufacturer Phone9702217063
Manufacturer G1WATER PIK, INC.
Manufacturer Street1730 EAST PROSPECT ROAD
Manufacturer CityFORT COLLINS CO 805530001
Manufacturer CountryUS
Manufacturer Postal Code805530001
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameWATERPIK WATER FLOSSER
Generic NameORAL IRRIGATOR
Product CodeEFS
Date Received2016-01-20
Returned To Mfg2016-01-21
Model NumberWP-72
Lot Number140310AJ
OperatorLAY USER/PATIENT
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerWATER PIK, INC.
Manufacturer Address1730 EAST PROSPECT ROAD FORT COLLINS CO 805530001 US 805530001


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2016-01-20

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