FDA Adverse Event Other Summary report: N

CVS

MDR report key: 3783532 · Received April 15, 2014

Report

Report Number
1038758-2014-00012
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
NY, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

ON (B)(6) 2014: THE CONSUMER REPORTED A BAD RASH THAT REQUIRED A CREAM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
230860 CVS SHEER 3/4" 40 CT BANDAGES KGX ASO LLC 05042834471 UNK

Patients

Seq Age Sex Outcome Treatment
1 Other