BEUDAMED
    FDA Adverse Event Other Summary report: N

    WALGREENS INSTANT COLD PECK

    MDR report key: 6198140 · Received December 20, 2016

    Report

    Report Number
    MW5066846
    Event Type
    Other
    Date Received
    December 20, 2016
    Date of Event
    November 28, 2016
    Report Date
    December 2, 2016
    Manufacturer
    WALGREENS
    Product Code
    IME
    Report Source
    Voluntary report
    Reporter Location
    IL, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    USER STATED THAT THE INSTANT COLD PACK BROKE AND CONTENTS WENT DOWN HIS ARM. RINSED OFF WITH WATER BUT REPORTS ALLEGEDLY GETTING "CHEMICAL BURNS" FROM THE PRODUCT AS A RESULT OF SKIN CONTACT WITH CONTENTS. DIAGNOSIS OR REASON FOR USE: APPLY TO BROKEN RIBS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    840729 WALGREENS INSTANT COLD PECK COLD PACK IME WALGREENS 06042016

    Patients

    Seq Age Sex Outcome Treatment
    1 62 YR