FDA Adverse Event
Injury
Summary report: N
MASK
MDR report key: 11854696
·
Received May 19, 2021
Report
- Report Number
- MW5101430
- Event Type
- Injury
- Date Received
- May 19, 2021
- Date of Event
- May 17, 2021
- Report Date
- May 17, 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
I AM REQUIRED TO WEAR I MASK AT WORK. I CONTINUALLY SUFFER FROM HEADACHES, MIGRAINES, SHORTNESS OF BREATH, FATIGUE AND OVERHEATING. FDA SAFETY REPORT ID # (B)(4).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 742842 | MASK | FACE MASK PER ENFORCEMENT POLICY FOR FACE MASKS AND RESPIRATORS DURING THE COVID | QKR | UNK |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Disability |