BEUDAMED
    FDA Adverse Event Other Summary report: N

    DOLLAR GENERAL-REXALL

    MDR report key: 3004170 · Received March 12, 2013

    Report

    Report Number
    1038758-2013-00014
    Event Type
    Other
    Date Received
    March 12, 2013
    Date of Event
    July 30, 2012
    Report Date
    March 12, 2013
    Manufacturer
    ASO LLC
    Product Code
    KGX
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TN, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4).

    Description of Event or Problem · 1

    THE CONSUMER COMPLAINED THAT THE BANDAGE ON DAUGHTER'S ARM CAUSED A CHEMICAL BURN. THE BURN WAS TREATED WITH ANTIBIOTIC.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    103400 DOLLAR GENERAL-REXALL ADHESIVE BANDAGES KGX ASO LLC 017276226027 170662

    Patients

    Seq Age Sex Outcome Treatment
    1 Other