FDA Adverse Event Other Summary report: N

ANCHOR FIX MULTI-PURPOSE COVER TAPE

MDR report key: 604874 · Received May 19, 2005

Report

Report Number
2939821-2005-00002
Event Type
Other
Date Received
May 19, 2005
Date of Event
April 27, 2005
Report Date
May 12, 2005
Manufacturer
NORTH COAST MEDICAL, INC.
Product Code
KGX
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
PHYSICAL THERAPIST

Narratives

Description of Event or Problem · 1

AFTER RECEIVING TREATMENT TO ALTER PATELLAR (KNEECAP) POSITIONING), PT EXPERIENCED SKIN IRRITATION WHEN ANCHOR FIX UNDERWRAP (ADHESIVE FABRIC TAPE) WAS REMOVED. ACCORDING TO THE PHYSICIAN THERAPIST, THERE WAS VERY MINOR IRRITATION AND IT WASN'T SIGNIFICANT ENOUGH TO DISUSE THE PRODUCT. THE PHYSICAL THERAPIST NOTED THAT THIS TYPE OF MINOR REACTION IS COMMON WITH ADHESIVE FABRIC TAPING. THIS PT DID NOT EXPERIENCED ADDITIONAL IRRITATION WITH CONTINUED USE OF THE ANCHOR FIX.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ANCHOR FIX MULTI-PURPOSE COVER TAPE ADHESIVE FABRIC TAPE (UNDERWRAP) KGX NORTH COAST MEDICAL, INC. NC22001-2 A0416

Patients

Seq Age Sex Outcome Treatment
1 56 YR Other