FDA Adverse Event Other Summary report: N

DEROYAL

MDR report key: 3138131 · Received May 24, 2013

Report

Report Number
3005225477-2013-00007
Event Type
Other
Date Received
May 24, 2013
Date of Event
May 1, 2013
Report Date
May 1, 2013
Manufacturer
DEROYAL GUATEMALA
Product Code
FOK
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SA
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

DESCRIBE EVENT OR PROBLEM: THE MEDICAL CENTER REPORTED THAT THE NEONATAL EYE COVERS WERE CAUSING RED IRRITATION ON THE BABIES IN THE ELASTIC AREA OF THE PRODUCT. DEROYAL: THE REPORTED DEVICE HAS BEEN RETURNED TO DEROYAL FOR EVAL. THERE HAVE BEEN NO ADDITIONAL COMPLAINTS FOR THIS PART NUMBER. THE INVESTIGATION INTO THE ROOT CAUSE HAS NOT BEEN COMPLETED AT THIS TIME.

Description of Event or Problem · 1

THE MEDICAL CENTER REPORTED THAT THE NEONATAL EYE COVERS WERE CAUSING RED IRRITATION ON THE BABIES IN THE ELASTIC AREA OF THE PRODUCT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
230537 DEROYAL FOK- PAD, NEONATAL EYE FOK DEROYAL GUATEMALA 24257581

Patients

Seq Age Sex Outcome Treatment
1 Other