BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    STOOL SAMPLE

    MDR report key: 12161407 · Received July 12, 2021

    Report

    Report Number
    MW5102516
    Event Type
    Malfunction
    Date Received
    July 12, 2021
    Date of Event
    June 28, 2021
    Report Date
    July 9, 2021
    Manufacturer
    UNK
    Product Code
    NNK
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    I SUSPECTED I HAD WORMS BECAUSE 2 PEOPLE I WAS AROUND SUSPECTED WORMS AND 1 OF THEM HAD FOUR BLOOD TRANSFUSIONS. I WENT TO (B)(6) MEDICAL CLINIC IN (B)(6) AND WAS GIVEN THE EQUIPMENT TO DO A STOOL SAMPLE, IE. PLASTIC BOWL, GLOVES CONTAINER AND BAGS. I WAS GIVEN MEDICINE FOR WORMS BEFORE THE RESULTS OF THE STOOL SAMPLE CAME BACK. I COULD CLEARLY SEE EGGS MARBLED IN MY POOP. I HAD A HISTAMINE REACTION 5 HOURS AFTER TAKING THE MEDICINE. THE STOOL SAMPLE CAME BACK NEGATIVE. THIS IS IMPOSSIBLE BECAUSE I COULD SEE THE WORM EGGS CLEARLY WITH THE NAKED EYE. MY DOCTOR IS DR. (B)(6), D.O. IN (B)(6) AND THE NURSE PRACTITIONER WHO ORDERED THE TEST IS NAMED (B)(6). THERE IS NO WAY THIS TEST SHOULD BE NEGATIVE. I COULD VISUALLY SEE THE EGGS. DR. (B)(6) SAID I HAD A CLASSIC CASE OF PINWORMS AFTER I TOLD HIM MY SYMPTOMS AND TOLD HIM WHAT I HAD BEEN SEEING IN MY STOOL. I WAS ALSO TREATED IN THE EMERGENCY ROOM AT (B)(6) HOSPITAL ON (B)(6) STREET IN (B)(6). MY FRIEND MR. (B)(6) ALSO GAVE A STOOL SAMPLE AND WAS TREATED PROACTIVELY FOR WORMS AT (B)(6) REGIONAL HOSPITAL IN (B)(6). I DO NOT KNOW THE RESULTS OF HIS STOOL SAMPLE. COMPANY: UNK TO ME, HOSPITAL KNOWS. FDA SAFETY REPORT ID# (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1052835 STOOL SAMPLE CONTAINER, SPECIMEN MAILER AND STORAGE, NON-STERILE NNK UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 47 YR