MAUDE MDR 8632535

MDR report key
8632535
Report number
1530449-2019-00002
Event key
0
Event type
3
Date received
2019-05-22
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MGR. REGULATORY ORAL CARE
Address
8700 MASON-MONTGOMERY RD MASON OH 45040 US
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1FIXODENT ADHESIVE ORIGINAL CREAM, NO FLAVORADHESIVE, DENTUREPROCTER & GAMBLE MANUFACTURING CO.KOONOT AVAILABLER N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-05-2201. R

Event Narratives#

N

Patient 1

PRODUCT RETURN WAS REQUESTED AND A FOLLOW-UP QUESTIONNAIRE HAS BEEN SENT TO THE REPORTER, BUT NEITHER HAS BEEN RECEIVED AT THIS TIME. AS A VALID PRODUCTION CODE HAS NOT BEEN PROVIDED BY THE REPORTER, NO FURTHER PRODUCT INVESTIGATION IS POSSIBLE AT THIS TIME. FURTHER EVALUATION WILL OCCUR UPON RECEIPT OF THE CONSUMER PRODUCT AND/OR THE QUESTIONNAIRE.

D

Patient 1

FIXODENT STUCK IN ESOPHAGUS [FOREIGN BODY IN GASTROINTESTINAL TRACT]. VOMITING, PINK STICKY STUFF IN VOMIT [VOMITING]. NAUSEA [NAUSEA]. FIXODENT DOES NOT HOLD WELL [DEVICE INEFFECTIVE]. SOMETIMES APPLY FIXODENT TWICE A DAY [DEVICE USED FOR UNAPPROVED SCHEDULE]. CASE DESCRIPTION: A SPONTANEOUS REPORT WAS RECEIVED VIA PHONE ON 22-APR-2019 FROM A (B)(6) YEAR OLD FEMALE CONSUMER STATING SHE USED FIXODENT ADHESIVE ORIGINAL CREAM, NO FLAVOR, AND SHE CURRENTLY HAD 2 TUBES OF FIXODENT DENTURE CARE DENTURE ADHESIVE ORIGINAL CREAM NO FLAVOR-SCENT .75OZ, TO HOLD HER BOTTOM PARTIAL DENTURE BEGINNING ON AN UNSPECIFIED DATE, AND EXPERIENCED NAUSEA AND VOMITING BEGINNING ON AN UNSPECIFIED DATE. SHE REPORTED SHE FOLLOWED THE INSTRUCTIONS FOR USE ON THE PRODUCT BOX, BUT THE PRODUCT DID NOT HOLD WELL. THE HOLD WOULD DISAPPEAR AFTER A FEW HOURS, AND SOMETIMES SHE HAD TO APPLY THE PRODUCT TWICE A DAY. SHE VISITED A DOCTOR WHO PERFORMED AN ENDOSCOPY, AND FIXODENT WAS FOUND STUCK IN HER ESOPHAGUS. THE CONSUMER REPORTED THE DOCTOR SAID THIS WAS THE CAUSE OF THE NAUSEA AND VOMITING, AND THE CONSUMER HAD NOTICED PINK STICKY STUFF IN HER VOMIT AS WELL. SHE STATED THE FIXODENT WAS CLEANED FROM HER ESOPHAGUS, AND SHE WAS GIVEN MEDICATION FOR NAUSEA. THE OUTCOME OF FIXODENT STUCK IN ESOPHAGUS WAS RECOVERED. THE OUTCOMES OF NAUSEA AND VOMITING WERE IMPROVED. THE CASE OUTCOME WAS IMPROVED. MEDICAL HISTORY: DENTURE WEARER (PARTIAL DENTURE). THE CONSUMER REPORTED HER LAST DENTURE FITTING WAS 2 YEARS AGO, AND HER DENTURE FIT WELL. CONCOMITANT PRODUCT(S): NONE REPORTED. NO FURTHER INFORMATION WAS PROVIDED.