BEUDAMED
    FDA Adverse Event Other Summary report: N

    FAMILY DOLLAR MULTIPURPOSE NO RUB

    MDR report key: 536109 · Received July 22, 2004

    Report

    Report Number
    2026940-2004-00001
    Event Type
    Other
    Date Received
    July 22, 2004
    Date of Event
    April 16, 2004
    Report Date
    July 15, 2004
    Manufacturer
    CIBA VISION STERILE MFR
    Product Code
    LPN
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    CA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    COMPLAINANT USED SOLUTION FOR THE FIRST TIME AT 11AM. BY 3PM, THEIR EYES WERE WATERY, ITCHY AND SWOLLEN. PT RETURNED THE CONTACTS. SEEN BY THEIR DOCTOR IN 4/04. THE EYES REMAIN SENSITIVE TO BRIGHT LIGHT OR DURING AT NIGHT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 FAMILY DOLLAR MULTIPURPOSE NO RUB MULTIPURPOSE SOLUTION LPN CIBA VISION STERILE MFR NA *

    Patients

    Seq Age Sex Outcome Treatment
    1 29 YR Other