FDA Adverse Event
Other
Summary report: N
2244031-1999-00003
MDR report key: 257556
·
Received December 30, 1999
Report
- Report Number
- 2244031-1999-00003
- Event Type
- Other
- Date Received
- December 30, 1999
- Date of Event
- August 1, 1999
- Report Date
- December 22, 1999
- Removal / Correction Number
- NA
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- OR, US
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
CONSUMER ALLEGES SHE HAD A SEVERE ALLERGIC REACTION TO THE PRODUCT.
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNKNOWN | Required Intervention |