FDA Adverse Event Other Summary report: N

EPICERAM SKIN BARRIER EMULSION

MDR report key: 1622864 · Received March 1, 2010

Report

Report Number
3006279883-2010-00003
Event Type
Other
Date Received
March 1, 2010
Report Date
January 14, 2010
Manufacturer
CERAGENIX PHARMACEUTICALS, INC.
Product Code
FRO
PMA / PMN Number
K052643
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

CERAGENIX IS PROVIDING THIS INFO TO ADDRESS THE PHYSICIAN REQUEST ALTHOUGH THE PHYSICIAN CONFIRMED AND STATED THAT, PER THEIR MEDICAL OPINION, THIS EVENT WOULD NOT HAVE CAUSED PERMANENT DAMAGE OR INJURY WITH OR WITHOUT TREATMENT.

Description of Event or Problem · 1

REPORT RECEIVED FROM DISTRIBUTOR (B)(6) 2010. THE PT, HAVING BEEN PRESCRIBED EPICERAM FOR AN UNK FACIAL ISSUE, DEVELOPED AN ALLERGIC CONTACT DERMATITIS. THE PHYSICIAN CONTACTED INDICATED THE PT WAS TREATED WITH AN UNK STEROID, UNK DOSAGE OR STRENGTH. THE PHYSICIAN INDICATED THAT EVEN WITHOUT TREATMENT WITH A STEROID, THIS EVENT WOULD NOT HAVE RESULTED IN PERMANENT INJURY OR ILLNESS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 EPICERAM SKIN BARRIER EMULSION NONE FRO CERAGENIX PHARMACEUTICALS, INC.

Patients

Seq Age Sex Outcome Treatment
1 Other PHYSICIAN DID NOT INDICATE OTHER PRODUCTS IN USE.