BEUDAMED
    FDA Adverse Event Other Summary report: N

    CONVERSE EYEGLASSES

    MDR report key: 3667625 · Received March 4, 2014

    Report

    Report Number
    MW5034822
    Event Type
    Other
    Date Received
    March 4, 2014
    Date of Event
    February 20, 2014
    Report Date
    February 24, 2014
    Product Code
    HQZ
    Report Source
    Voluntary report
    Reporter Location
    TN, US
    Reporter Occupation
    PATIENT FAMILY MEMBER OR FRIEND

    Narratives

    Description of Event or Problem · 1

    MY SON HAS A PAIR OF PRESCRIPTION (B)(6) EYEGLASSES, MODEL WHY 49-15-130. HE AND A FRIEND WERE PLAYING ON THE PLAYGROUND AND HIS GLASSES BROKE ON THE FRONT EDGE OF THE FRAME AND CREATED A SHARP, KNIFELIKE EDGE. THE FRAME ITSELF BROKE, NOT AT THE HINGE. THE LENS DID NOT BREAK. THIS SHARP EDGE CUT HIM ON HIS EYEBROW. IT WAS ABOUT AN INCH AND A HALF LACERATION AND REQUIRED EIGHT STITCHES. I AM REPORTING THIS BECAUSE I FEEL IT IS A SAFETY ISSUE WHICH COULD HAVE RESULTED IN A MUCH MORE SERIOUS INJURY. (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    129913 CONVERSE EYEGLASSES CONVERSE BOYS EYEGLASSES BLACK AND WHITE HQZ WHY 49-15-130

    Patients

    Seq Age Sex Outcome Treatment
    1 12 YR