FDA Adverse Event
Malfunction
Summary report: N
NA
MDR report key: 10801502
·
Received November 6, 2020
Report
- Report Number
- 1523658-2020-00170
- Event Type
- Malfunction
- Date Received
- November 6, 2020
- Date of Event
- August 21, 2020
- Report Date
- November 5, 2020
- Manufacturer
- BATTELLE MEMORIAL INSTITUTE
- Product Code
- QKY
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
DEVICE NOT RETURNED. CCDS STAFF HAS BEEN IN CONTACT WITH HCP AS WELL AS SENT GUIDANCE TO SITES TO TAKE CARE WHEN HANDLING MASKS DURING LOADING, UNLOADING AND PACKAGING.
Description of Event or Problem · 1
USER REPORTED STRAPS BROKE. THE MASKS ASSOCIATED WITH THIS EVENT WERE DECONTAMINATED WITH THE BATTELLE CCDS "CLOSED SYSTEM" PROCESS.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1264486 | NA | RESPIRATOR, DECONTAMINATED | QKY | BATTELLE MEMORIAL INSTITUTE |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |