FDA Adverse Event Other Summary report: N

DERMA PRENE ISOTOUCH MICRO WHITE

MDR report key: 2413010 · Received January 10, 2012

Report

Report Number
1019632-2012-00002
Event Type
Other
Date Received
January 10, 2012
Report Date
January 10, 2012
Manufacturer
ANSELL LANKA (PVT) LTD.
Product Code
LZC
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

CUSTOMER STATES THAT THE EMPLOYEE IS ALLERGIC TO LATEX AND USED THE DERMA PRENE ISOTOUCH WHITE GLOVE, HOWEVER INSIDE WAS A LATEX GLOVE. THE EMPLOYEE WENT INTO A 'ANAPHYLACTIC SHOCK' AS A RESULT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DERMA PRENE ISOTOUCH MICRO WHITE SYNTHETIC SURGICAL GLOVE LZC ANSELL LANKA (PVT) LTD. 1106006605

Patients

Seq Age Sex Outcome Treatment
1 Other