BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CAVICIDE

    MDR report key: 3761550 · Received April 21, 2014

    Report

    Report Number
    1722021-2014-00008
    Event Type
    Injury
    Date Received
    April 21, 2014
    Date of Event
    April 3, 2014
    Report Date
    April 3, 2014
    Manufacturer
    METREX RESEARCH
    Product Code
    LRJ
    PMA / PMN Number
    K951123
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NV, US
    Reporter Occupation
    PATIENT

    Narratives

    Additional Manufacturer Narrative · 1

    NO CATALOG NUMBER, LOT NUMBER, OR EXPIRATION DATE WAS PROVIDED; THEREFORE, NO INFORMATION COULD BE PROVIDED. IT WAS REPORTED THAT THE PATIENT HAD SOUGHT MEDICAL ATTENTION AT THE EMERGENCY ROOM AND WAS PRESCRIBED EYE DROPS. THE PATIENT HAD RETURNED TO THE OFFICE ON (B)(6) 2014, FOR A FOLLOW UP APPOINTMENT. THE DOCTOR TOLD HER TO FINISH TAKING HER PRESCRIPTION AND HER EYE WILL BE FINE. DURING A FOLLOW UP PHONE CALL WITH THE COMPLAINANT ON (B)(6) 2014, IT WAS REPORTED THAT TO DATE, SHE IS DOING FINE. THE PRODUCT WAS NOT RETURNED AND NO LOT NUMBER WAS PROVIDED; THEREFORE, NO EVALUATION CAN BE CONDUCTED.

    Description of Event or Problem · 1

    A COMPLAINANT ALLEGED THAT A DENTAL OFFICE WAS SPRAYING CAVICIDE AND SOME OF THE SOLUTION GOT ON HER FACE AND EYE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    239893 CAVICIDE SURFACE DISINFECTANT LRJ METREX RESEARCH

    Patients

    Seq Age Sex Outcome Treatment
    1 71 YR Other| R