FDA Adverse Event Summary report: N

N95 MASK

MDR report key: 11010617 · Received December 11, 2020

Report

Report Number
MW5098352
Date Received
December 11, 2020
Date of Event
December 2, 2020
Report Date
December 11, 2020
Manufacturer
XIANTAO ZHONGYI SAFETY & PROTECTING PRODUCTS CO., LTD
Product Code
NZJ
Report Source
Voluntary report
Reporter Location
OR, US
Reporter Occupation
DENTAL HYGIENIST

Narratives

Description of Event or Problem · 1

A REPORTER STATED AN EMPLOYEE WHO WAS WEARING THE N95 MASK AT HER JOB ON DECEMBER 2 AND 3 WHEN SHE IS IN CONTACT OF PATIENTS IS HAVING SYMPTOMS SIMILAR TO COVID-19. REPORTER SAID THE EMPLOYEE HAS TAKEN THE TEST AND WAITING FOR THE RESULTS. REPORTER SAID THEY ARE NOT SURE IF THE EMPLOYEE'S SYMPTOMS ARE RELATED TO COVID-19 YET BUT THEY WANTED TO REPORT THE INCIDENT PER THE REQUIREMENTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1459394 N95 MASK RESPIRATOR, N95, FOR USE BY THE GENERAL PUBLIC IN PUBLIC HEALTH MEDICAL EMERGENC NZJ XIANTAO ZHONGYI SAFETY & PROTECTING PRODUCTS CO., LTD ZYB-11
1459395 N95 MASK RESPIRATOR, N95, FOR USE BY THE GENERAL PUBLIC IN PUBLIC HEALTH MEDICAL EMERGENC NZJ XIANTAO ZHONGYI SAFETY & PROTECTING PRODUCTS CO., LTD ZYB-11

Patients

Seq Age Sex Outcome Treatment
1 22 YR