FDA Adverse Event
Other
Summary report: N
WALGREENS
MDR report key: 3783531
·
Received April 15, 2014
Report
- Report Number
- 1038758-2014-00011
- Event Type
- Other
- Date Received
- April 15, 2014
- Report Date
- April 14, 2014
- Manufacturer
- ASO LLC
- Product Code
- KGX
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IL, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Description of Event or Problem · 1
ON (B)(6) 2014: THE CONSUMER REPORTED A SKIN TEAR.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 230841 | WALGREENS | NASAL DILATOR CLEAR MEDIUM 30 COUNT | KGX | ASO LLC | 1191710768 | 136723 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |