BEUDAMED
    FDA Adverse Event Summary report: N

    LATEX EXAM GLOVE

    MDR report key: 34231 · Received July 18, 1996

    Report

    Report Number
    MW1009506
    Date Received
    July 18, 1996
    Date of Event
    June 16, 1996
    Report Date
    July 8, 1996
    Manufacturer
    CAL-AMERICAN EXPORTS, INC.
    Product Code
    LYY
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MS, US
    Reporter Occupation
    DENTIST

    Narratives

    Description of Event or Problem · 1

    WITHIN 1 TO 3 DAYS PT AHD ULCERATIONS AND BURNING OF LIP AND TONGUE AFTER ROUTINE DENTAL PROPHYLAXIS. RESPONDED TO MEDICATED RINSE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LATEX EXAM GLOVE LATEX EXAM GLOVE LYY CAL-AMERICAN EXPORTS, INC. 80905

    Patients

    Seq Age Sex Outcome Treatment
    1 70 YR