FDA Adverse Event Injury Summary report: N

GRANUFLO

MDR report key: 3111343 · Received May 9, 2013

Report

Report Number
3005162618-2013-00005
Event Type
Injury
Date Received
May 9, 2013
Date of Event
January 19, 2012
Report Date
April 9, 2013
Manufacturer
FRESENIUS MEDICAL CARE NORTH AMERICA
Product Code
KPO
PMA / PMN Number
K030497
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

BASED ON THE INFO PROVIDED, NO DEFINITIVE CONCLUSION CAN BE DRAWN. CURRENTLY, MEDICAL RECORDS HAVE NOT BEEN PROVIDED. PRODUCT IDENTIFIERS ARE UNK THEREFORE A MFG REVIEW CANNOT BE PERFORMED. A SUPPLEMENTAL REPORT WILL BE SUBMITTED IF ADD¿L INFO BECOMES AVAILABLE.

Description of Event or Problem · 1

IT WAS ALLEGED THAT ON (B)(6) 2012 A PCT (PATIENT CARE TECHNICIAN) SPLASHED DIALYZER EFFLUENT INTO HER RIGHT EYE THAT GOT UNDER HER FACE SHIELD. SHE SOUGHT MEDICAL CARE FOR ONE VISIT ON THE SAME DATE. SHE HAS SINCE BEEN DISCHARGED FROM CARE WITH NO RESULTING DISABILITY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
204951 GRANUFLO KPO FRESENIUS MEDICAL CARE NORTH AMERICA

Patients

Seq Age Sex Outcome Treatment
1 35 YR Other