BEUDAMED
    FDA Adverse Event Other Summary report: N

    CVS

    MDR report key: 3772104 · Received April 14, 2014

    Report

    Report Number
    1038758-2014-00010
    Event Type
    Other
    Date Received
    April 14, 2014
    Report Date
    April 11, 2014
    Manufacturer
    ASO LLC
    Product Code
    LWF
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    RI, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    ON (B)(4) 2014 - THE CUSTOMER REPORTED A BRUISED NOSE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    228089 CVS NASAL DILATOR 4-TOUCH CLEAR 10 CT LWF ASO LLC 50428470817 00003657

    Patients

    Seq Age Sex Outcome Treatment
    1 Other