BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CVS

    MDR report key: 4975925 · Received August 4, 2015

    Report

    Report Number
    1038758-2015-00060
    Event Type
    Injury
    Date Received
    August 4, 2015
    Report Date
    August 4, 2015
    Manufacturer
    ASO LLC
    Product Code
    KGX
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    RI, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    THE CONSUMER HAS NOT PROVIDED SAMPLES OF THE DEVICE OR THE LOT NUMBER.

    Description of Event or Problem · 1

    ON (B)(6) 2015 - THE END USER REPORTED THAT THE END ITEM RIPPED OFF SOME SKIN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    509319 CVS ADHESIVE BANDAGE KGX ASO LLC UPC 050428120620

    Patients

    Seq Age Sex Outcome Treatment
    1