LISTERINE SENSITIVITY ZERO ALCOHOL MOUTHRINSE FRESH MINT

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer report with the FDA on 2018-11-08 for LISTERINE SENSITIVITY ZERO ALCOHOL MOUTHRINSE FRESH MINT manufactured by Johnson & Johnson Consumer Inc.

Event Text Entries

[126600076] Device was used for treatment, not diagnosis. Ethnicity/race were not provided for reporting. This report is for listerine sensitivity zero alcohol mouthrinse. Upc#, lot# and udi # is not available. Device is not expected to be returned for manufacturer review/investigation. Concomitant medical products and therapy dates: drug: unspecified thyroid medication; 1x daily; consumer still on drug. Drug: unspecified high blood pressure medication; 1x daily; consumer still on drug. (b)(4). Device evaluation/investigation could not be completed; no conclusion could be drawn as product was not returned to manufacturer. This is one of two medwatches being submitted as two devices were involved with this consumer. See medwatch 2214133-2018-00051. The same consumer is represented in each medwatch. If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
Patient Sequence No: 1, Text Type: N, H10


[126600077] A 5'8" (b)(6) male consumer reported an adverse event while using listerine sensitivity mouthwash. The consumer orally used, a couple teaspoons-full, twice a day of listerine sensitivity mouthwash and he developed sloshing of his gums, sores and the listerine burns his gums. The consumer states that he had tremendous discomfort while using the product. This was the consumer's first time using the product and it was to help with tooth sensitivity. Consumer was not certain the start date or length of use. Consumer has never had a similar experience before and is still experiencing peeling of his gums. Consumer did go to the orthodontist and his hcp recommended to discontinue use of the product, rinse with salt water, take ibuprofen, and a prescription mouthwash. Consumer did not go to the er and did not receive laboratory testing. Consumer is still experiencing the symptoms. This is one of two medwatches being submitted as two devices were involved with this consumer.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2214133-2018-00052
MDR Report Key8052279
Report SourceCONSUMER
Date Received2018-11-08
Date of Report2018-10-15
Date Mfgr Received2018-10-15
Date Added to Maude2018-11-08
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional0
Initial Report to FDA0
Report to FDA3
Event Location3
Manufacturer ContactLINDA PLEWS
Manufacturer Street199 GRANDVIEW RD
Manufacturer CitySKILLMAN NJ 085589418
Manufacturer CountryUS
Manufacturer Postal085589418
Manufacturer Phone2152737120
Manufacturer G1KIK CUSTOM PRODUCTS - KIK REXDALE
Manufacturer Street2000 KIPLING AVENUE ETOBICOKE
Manufacturer CityONTARIO M9W 4J6
Manufacturer CountryCA
Manufacturer Postal CodeM9W 4J6
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameLISTERINE SENSITIVITY ZERO ALCOHOL MOUTHRINSE FRESH MINT
Generic NameCAVITY VARNISH
Product CodeLBH
Date Received2018-11-08
OperatorLAY USER/PATIENT
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerJOHNSON & JOHNSON CONSUMER INC
Manufacturer Address199 GRANDVIEW ROAD SKILLMAN NJ 085589418 US 085589418


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2018-11-08

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