FDA Adverse Event
Injury
Summary report: N
VARIOUS MEDICAL MASK
MDR report key: 11612987
·
Received April 2, 2021
Report
- Report Number
- MW5100528
- Event Type
- Injury
- Date Received
- April 2, 2021
- Date of Event
- April 1, 2021
- Report Date
- April 1, 2021
- Manufacturer
- UNK
- Product Code
- QKR
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Voluntary report
- Reporter Occupation
- PATIENT
Narratives
Description of Event or Problem · 1
DAILY HEADACHE. BREATHING DIFFICULTY. INCREASED ACNE AND SKIN IRRITATION. DECREASED BLOOD O2 SATURATION. FDA SAFETY REPORT ID # (B)(4).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 508975 | VARIOUS MEDICAL MASK | FACE MASK PER ENFORCEMENT POLICY FOR FACE MASKS AND RESPIRATORS DURING THE COVID | QKR | UNK |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 42 YR |