MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer report with the FDA on 2019-04-30 for LISTERINE GENTLE GUM CARE FLOSS MINT 12547440225 manufactured by Johnson & Johnson Consumer Inc.
[143667426]
Device was used for treatment, not diagnosis. Ethnicity/race was not provided for reporting. (b)(4), expiration date - na, lot number - 3477d. Device is not expected to be returned for manufacturer review/investigation. Device evaluation/investigation could not be completed; no conclusion could be drawn as product was not returned to manufacturer. A review of the device history records has been requested. 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
[143667427]
A female consumer reported an event with (b)(6) gentle gum care floss mint 5yd. The consumer stated that on (b)(6) 2019 a ball of floss got stuck between her teeth. The consumer sought medical attention from her dentist. The dentist removed the floss. The consumer is no longer experiencing any symptoms.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 8041101-2019-00039 |
| MDR Report Key | 8566577 |
| Report Source | CONSUMER |
| Date Received | 2019-04-30 |
| Date of Report | 2019-05-11 |
| Date of Event | 2019-04-02 |
| Date Mfgr Received | 2019-05-11 |
| Device Manufacturer Date | 2018-12-13 |
| Date Added to Maude | 2019-04-30 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 0 |
| Initial Report to FDA | 0 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | LINDA PLEWS |
| Manufacturer Street | 199 GRANDVIEW RD |
| Manufacturer City | SKILLMAN NJ 085589418 |
| Manufacturer Country | US |
| Manufacturer Postal | 085589418 |
| Manufacturer Phone | 2152737120 |
| Manufacturer G1 | JOHNSON & JOHNSON CONSUMER PRODUCTS DR PARQUE INDU |
| Manufacturer Street | CARRETERA S |
| Manufacturer City | HAINA 91000 |
| Manufacturer Country | DR |
| Manufacturer Postal Code | 91000 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | LISTERINE GENTLE GUM CARE FLOSS MINT |
| Generic Name | DENTAL FLOSS |
| Product Code | JES |
| Date Received | 2019-04-30 |
| Model Number | 12547440225 |
| Lot Number | 3477D |
| Operator | LAY USER/PATIENT |
| Device Availability | N |
| Device Age | DA |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | JOHNSON & JOHNSON CONSUMER INC |
| Manufacturer Address | 199 GRANDVIEW ROAD SKILLMAN NJ 085589418 US 085589418 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2019-04-30 |