FDA Adverse Event
Injury
Summary report: N
MASK
MDR report key: 11731344
·
Received April 26, 2021
Report
- Report Number
- MW5100982
- Event Type
- Injury
- Date Received
- April 26, 2021
- Date of Event
- April 21, 2021
- Report Date
- April 22, 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
HAD TO LEAVE JOB DUTIES; WHILE WEARING MASK AT WORK, I BECAME DIZZY AND FELT FAINT. I BELIEVE IT WAS BECAUSE I WASN'T GETTING ENOUGH OXYGEN. THIS WAS A THIRD INCIDENT. FDA SAFETY REPORT ID # (B)(4).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 618421 | MASK | FACE MASK PER ENFORCEMENT POLICY FOR FACE MASKS AND RESPIRATORS DURING THE COVID | QKR | UNK | |||
| 618422 | MASK | FACE MASK PER ENFORCEMENT POLICY FOR FACE MASKS AND RESPIRATORS DURING THE COVID | QKR | UNK | |||
| 618423 | MASK | FACE MASK PER ENFORCEMENT POLICY FOR FACE MASKS AND RESPIRATORS DURING THE COVID | QKR | UNK |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 61 YR | Other |