BEUDAMED
    FDA Adverse Event Other Summary report: N

    ANCHOR FIX MULTI-PURPOSE COVER TAPE

    MDR report key: 604891 · Received May 19, 2005

    Report

    Report Number
    2939821-2005-00003
    Event Type
    Other
    Date Received
    May 19, 2005
    Date of Event
    May 5, 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 PHYSICAL THERAPIST, THERE WAS MINOR RED IRRITATION WITH SMALL BUMPS. ACCORDING TO THE PHYSICAL THERAPIST, THIS ISN'T FAR FROM AN ORDINARY REACTION TO ADHESIVE FABRIC TAPING. PT HAD LEFT ANCHOR FIX ON FOR 2 DAYS BEFORE REMOVAL.

    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 32 YR Other