BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CAVILON NO STING BARRIER FILM - 3M

    MDR report key: 1230090 · Received November 13, 2008

    Report

    Report Number
    MW5008965
    Event Type
    Injury
    Date Received
    November 13, 2008
    Date of Event
    November 5, 2008
    Report Date
    November 6, 2008
    Product Code
    KOY
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    WA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    WHEN USING ELECTROSURGICAL PENCIL TO CAUTERIZE BLEEDING AROUND SURGICAL WOUND, VAPORS FROM CAVILON BARRIER FILM PAD IGNITED, CAUSING CAVILON PAD TO CATCH FIRE AND BURN. DIAGNOSIS OR REASON FOR USE: CLEANING SKIN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CAVILON NO STING BARRIER FILM - 3M NONE KOY 38-9019-0529-9

    Patients

    Seq Age Sex Outcome Treatment
    1 82 YR