BEUDAMED
    FDA Adverse Event Injury Summary report: N

    TAPE ++ ADHESIVE REMOVER

    MDR report key: 14111840 · Received April 13, 2022

    Report

    Report Number
    MW5108991
    Event Type
    Injury
    Date Received
    April 13, 2022
    Report Date
    April 11, 2022
    Manufacturer
    UNK
    Product Code
    KOX
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL
    Health Professional
    Yes

    Narratives

    Description of Event or Problem · 0

    CALL FROM PATIENT REGARDING ADHESIVE REMOVERS WE HAD SENT HIM IN THE PAST. HE HAD SOME ISSUES WITH HAVING A RASH AFTER USING THEM, BUT WAS UNSURE OF THE EXACT PRODUCT NUMBER. SENDING 3 DIFFERENT TYPES OF ADHESIVE REMOVERS IN HOPES THAT 1 OF THEM WORKS FOR HIM. REPORTED TO (B)(6)/CAREMARK BY PT/CAREGIVER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    173514 TAPE ++ ADHESIVE REMOVER SOLVENT, ADHESIVE TAPE KOX UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 Male