FDA Adverse Event Summary report: N

CHILD SIZE SAFETY GOGGLES

MDR report key: 6529379 · Received April 26, 2017

Report

Report Number
MW5069379
Date Received
April 26, 2017
Report Date
April 17, 2017
Manufacturer
UNK
Product Code
HOY
Report Source
Voluntary report
Reporter Location
SD, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

I WORK FOR AN OCCUPATIONAL SAFETY WORK CENTER SO IT IS OUR RESPONSIBILITY TO ENSURE ALL WORK CENTERS ON OUR INSTALLATION ARE FOLLOWING THE FEDERAL REGULATIONS SET BY OSHA AND THE U.S. AIR FORCE. WHILE ON AN INSPECTION OF A WORK CENTER, ONE OF OUR INSPECTORS CAME ACROSS SOME CHILD SAFETY GOGGLES IN ONE OF OUR YOUTH WORK CENTERS. THEY WERE STILL IN THE PACKAGE SO THE INSPECTOR PICKED THEM UP TO ENSURE THEY MEET ANSI Z87.1 STANDARDS. AS THEY WERE PICKED UP THE LENSES CRACKED. THE SAFETY GOGGLES DID HAVE A "Z87" STAMP ON THE GOGGLES BUT THERE WAS NO MANUFACTURER'S STAMP ON THEM. ONLY A "(B)(6)" STAMP WAS FOUND ON THE GOGGLES. THE GOGGLES WERE MANUFACTURED BY (B)(4), PART NUMBER 190-0030, CHILD SIZE SAFETY GOGGLES. DO THESE GOGGLES MEET ANSI Z87.1 STANDARDS OR IS THERE A CHANCE THEY WOULD BE FAKE? INCIDENT LOCATION: (B)(4). PRODUCT DESCRIPTION: DELTA EDUCATION CHILD SIZE SAFETY GOGGLES, PART NUMBER 190-0030. BLUE STRAP. CRANKED IN THE PACKAGING UPON PICKING UP. NO MANUFACTURER'S STAMP LOCATED ON THE GOGGLES, ONLY A "Z87" AND "(B)(6)" STAMP WAS FOUND. BRAND NAME: (B)(4). MANUFACTURER/ IMPORTER: (B)(4). DOCUMENT NUMBER: (B)(4). REPORT NUMBER: (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
306380 CHILD SIZE SAFETY GOGGLES SAFETY GOGGLES HOY UNK

Patients

Seq Age Sex Outcome Treatment
1