FDA Adverse Event Other Summary report: N

ETHYL CHLORIDE SPRAY TOPICAL ANESTHETIC BOTTLE 3.5 FL. OZ

MDR report key: 5350376 · Received January 5, 2016

Report

Report Number
MW5058987
Event Type
Other
Date Received
January 5, 2016
Manufacturer
GEBAUER COMPANY
Product Code
MLY
Report Source
Voluntary report
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

PATIENT PRESENTED TO CLINIC FOR A STEROID INJECTION INTO A JOINT. THE PHYSICIAN WAS PREPARING TO APPLY ETHYL CHLORIDE TO THE SKIN SITE. SHE HEARD A FAINT HISSING SOUND AND THEN THE TOP PIECE OF THE ETHYL CHLORIDE BOTTLE (THE SMALL BLACK PIECE THAT IS ATTACHED TO THE METAL SPRAY TRIGGER) DISLOCATED FROM THE LARGER BLACK SCREW TOP PIECE OF THE BOTTLE. THE PIECE SHOT INTO THE AIR AND HIT THE PATIENT ON THE FOREHEAD. THE PATIENT WAS NOT INJURED. PATIENT COUNSELING PROVIDED: (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
5612 ETHYL CHLORIDE SPRAY TOPICAL ANESTHETIC BOTTLE 3.5 FL. OZ ETHYL CHLORIDE SPRAY TOPICAL ANESTHETIC BOTTLE 3.5 FL. OZ MLY GEBAUER COMPANY

Patients

Seq Age Sex Outcome Treatment
1