FDA Adverse Event Injury Summary report: N

CHLORAPREP UNKNOWN

MDR report key: 13561002 · Received February 18, 2022

Report

Report Number
3004932373-2022-00055
Event Type
Injury
Date Received
February 18, 2022
Date of Event
January 26, 2022
Report Date
February 18, 2022
Manufacturer
CAREFUSION 213, LLC 0113
Product Code
KXG
PMA / PMN Number
EXEMPT
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4) INITIAL EMDR SUBMISSION. A FOLLOW UP EMDR WILL BE SUBMITTED IF ADDITIONAL INFORMATION BECOMES AVAILABLE. (B)(4). NO ADDITIONAL INFORMATION WAS PROVIDED BY (B)(6). PRIMEVIGILANCE DID REACH OUT TO OBTAIN MORE INFORMATION WITH NO SUCCESS. SHOULD ADDITIONAL INFORMATION BE AVAILABLE IN THE FUTURE, THE COMPLAINT WILL BE RE-OPENED AND INVESTIGATED. ALL COMPLAINTS ARE REVIEWED DURING MONTHLY QUALITY/SAFETY MEETINGS. IN ADDITION, COMPLAINTS ARE TRENDED AT MONTHLY QUALITY DATA ANALYST MEETINGS AND QUARTERLY PLANT MANAGEMENT REVIEW MEETINGS.

Description of Event or Problem · 0

IT WAS REPORTED THAT PATIENTS ARE HAVING A REACTION TO CHLORAPREP. VERBATIM: CHLORAPREP PART NO.: 930815 LOT NO.: UNKNOWN." COMPLAINT RECEIVED VIA PHONE CALL. IT WAS REPORTED "PATIENTS ARE HAVING REACTIONS TO THE ORANGE CHLORAPREP. 2 PATIENTS HAVE HAD SEVERE SKIN REACTIONS AND ARE ITCHING, WHEREVER IT WAS ORANGE." PART NO.: 930815 LOT NO.: UNKNOWN."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
530437 CHLORAPREP UNKNOWN 2% W/V CHLORHEXIDINE GLUCONATE/70% V/V ISOPROPYL ALCOHOL KXG CAREFUSION 213, LLC 0113 UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Unknown Other