BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PRESERVATION MEDIUM

    MDR report key: 3675292 · Received March 11, 2014

    Report

    Report Number
    MW5034886
    Event Type
    Injury
    Date Received
    March 11, 2014
    Date of Event
    August 29, 2006
    Report Date
    September 22, 2006
    Product Code
    LYX
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    AZ, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    (B)(6) FOR TRANSPLANT, RECEIVED A FAXED (B)(6) ADVERSE REACTION REPORT ON (B)(6) 2006 FROM DR (B)(6) FOR RECIPIENT (B)(6). CULTURE REPORT: SPECIMEN SOURCE: SWAB CORNEA, DONOR MEDIUM. RESULT: IT PROPIONI BACTERIUM ACNES. DR (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    145484 PRESERVATION MEDIUM LYX

    Patients

    Seq Age Sex Outcome Treatment
    1 88 YR CORNEAL TISSUE LOT 06-039900, EXP 9/8/2006