FDA Adverse Event Other Summary report: N

LIFESTYLES SKYN LARGE

MDR report key: 3163057 · Received May 9, 2013

Report

Report Number
1019632-2013-00013
Event Type
Other
Date Received
May 9, 2013
Report Date
May 9, 2013
Manufacturer
SURETEX LTD.
Product Code
HIS
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4) - ANSELL HEALTHCARE PRODUCTS LLC, IS SUBMITTING THIS REPORT ON BEHALF OF (B)(4).

Description of Event or Problem · 1

END USER ADVISED ANSELL HEALTHCARE LLC THAT AFTER USING LIFESTYLES SKYN LARGE CONDOM SHE AND HER PARTNER STARTED TO HAVE PAIN AND BURNING AND NEEDED MEDICAL ATTENTION. THE DOCTOR PRESCRIBED BOTH AN ANTIBIOTIC AND A CREAM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
205185 LIFESTYLES SKYN LARGE LUBRICATED POLYISOPRENE CONDOM HIS SURETEX LTD. 130218041C

Patients

Seq Age Sex Outcome Treatment
1 Other