FDA Adverse Event Other Summary report: N

METRICIDE OPA PLUS

MDR report key: 2648437 · Received June 28, 2012

Report

Report Number
1221361-2012-00001
Event Type
Other
Date Received
June 28, 2012
Report Date
June 24, 2012
Manufacturer
ALDEN MEDICAL LLC
Product Code
MED
PMA / PMN Number
K070627
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

AN INCOMPLETE DESCRIPTION OF THE EVENT WAS PROVIDED BY THE USER FACILITY TO THE DISTRIBUTOR. THE DISTRIBUTOR FORWARDED THIS DESCRIPTION TO THE MANUFACTURER. THE MANUFACTURER AND THE DISTRIBUTOR BOTH ATTEMPTED TO CLARIFY THE CORRELATION BETWEEN THE EVENT AND THE USE OF THE PRODUCT. SEVERAL ATTEMPTS WERE MADE TO CONTACT THE USER FACILITY IN ORDER TO OBTAIN MORE INFORMATION. HOWEVER, ALL ATTEMPTED REQUESTS FOR INFORMATION WERE IGNORED BY THE USER FACILITY. NO DETAILS ARE KNOWN ON WHAT ROLE, IF ANY, THE PRODUCT MAY HAVE PLAYED IN THE EVENT.

Description of Event or Problem · 1

A USER FACILITY WHICH USES THIS PRODUCT TO DISINFECT MEDICAL DEVICES INDICATED PATIENT REACTIONS MAY HAVE OCCURRED AFTER USING THIS PRODUCT ON EQUIPMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 METRICIDE OPA PLUS HIGH LEVEL DISINFECTANT MED ALDEN MEDICAL LLC NA 1811541

Patients

Seq Age Sex Outcome Treatment
1