BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    REDI-FOAM

    MDR report key: 198173 · Received November 13, 1998

    Report

    Report Number
    1932738-1998-00001
    Event Type
    Malfunction
    Date Received
    November 13, 1998
    Date of Event
    October 19, 1998
    Report Date
    November 13, 1998
    Manufacturer
    MED-TEC,INC.
    Product Code
    IWE
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    OPEN BOTTLE POPPED AND MADE A FOAM MESS IN SINK. NO ONE WAS INJURED AND ONLY EQUIPMENT WAS FOAMED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 REDI-FOAM FOAMING AGENT IWE MED-TEC,INC. MT-FA 38 1998

    Patients

    Seq Age Sex Outcome Treatment
    1 * Other