BEUDAMED
    FDA Adverse Event Other Summary report: N

    UNK

    MDR report key: 126173 · Received October 15, 1997

    Report

    Report Number
    MW1012279
    Event Type
    Other
    Date Received
    October 15, 1997
    Date of Event
    October 10, 1997
    Report Date
    October 15, 1997
    Manufacturer
    CITMED
    Product Code
    KXG
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    WI, US
    Reporter Occupation
    RADIOLOGIC TECHNOLOGIST

    Narratives

    Description of Event or Problem · 1

    WHILE PACKING A WOUND, THE WET COTTON TIP SEPARATED FROM THE STICK. THE TIP WAS REMOVED FROM THE WOUND WITHOUT INCIDENT. THE FACILITY DID SOME "TESTING" AND FOUND THAT THE COTTON TIPS EASILY SEPARATED FROM THE STICK AFTER APPROXIMATELY 1-1.5 MINUTES WHEN WET.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 UNK COTTON TIP APPLICATORS KXG CITMED NI NI

    Patients

    Seq Age Sex Outcome Treatment
    1 66 YR Other