BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CAVICIDE1

    MDR report key: 3261985 · Received August 2, 2013

    Report

    Report Number
    1722021-2013-00018
    Event Type
    Injury
    Date Received
    August 2, 2013
    Report Date
    July 17, 2013
    Manufacturer
    METREX RESEARCH
    Product Code
    LRJ
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MD, US
    Reporter Occupation
    MEDICAL ASSISTANT

    Narratives

    Additional Manufacturer Narrative · 1

    THE EMPLOYEE HAD SOUGHT MEDICAL ATTENTION WITH A GENERAL PHYSICIAN AND REFERRED TO AN ALLERGIST. THE EMPLOYEE HAS COMPLETED AN ALLERGY TEST; HOWEVER, NO ALLERGIES WERE DETERMINED. THE EMPLOYEE WAS PRESCRIBED FLONAZE AND EYE DROPS. TO DATE, THE EMPLOYEE IS FEELING BETTER. A DHR REVIEW REVEALED THAT THERE WERE NO DEVIATIONS FROM THE MANUFACTURING PROCESS; THE PRODUCT WAS RELEASED WITHIN SPECIFICATIONS AND ACCEPTABLE PARAMETERS.

    Description of Event or Problem · 1

    A COMPLAINANT ALLEGED THAT ONE (1) EMPLOYEE HAS EXPERIENCED A REACTION WITH SYMPTOMS OF COUGHING, EYE DRAINAGE, AND A REACTIVE AIRWAY AFTER THE FACILITY UNKNOWING REFILLED CAVICIDE1 INTO CAVICIDE SPRAY BOTTLES.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    362835 CAVICIDE1 SURFACE DISINFECTANT LRJ METREX RESEARCH 12-2125

    Patients

    Seq Age Sex Outcome Treatment
    1 50 YR Other| R CAVICIDE