BEUDAMED
    FDA Adverse Event Other Summary report: N

    KWIK KOOL ICE PACK

    MDR report key: 75570 · Received March 13, 1997

    Report

    Report Number
    1423537-1997-00041
    Event Type
    Other
    Date Received
    March 13, 1997
    Report Date
    March 13, 1997
    Manufacturer
    ALLEGIANCE-SURGICAL GRP
    Product Code
    IMD
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WV, US
    Reporter Occupation
    ATTORNEY

    Narratives

    Description of Event or Problem · 1

    WHEN A FORKLIFT OPERATOR BUMPED A PILE OF LUMBER CAUSING A NUMBER OF DOORS TO FALL ON THE PLAINTIFF CAUSING INJURY TO THE PLAINTIFF'S LEFT LEG. PLAINTIFF'S LEG WAS TREATED BY APPLYING A DEVICE INSTANT ICE PACK AND SECURING SAID ICE PACK WITH AN ACE BANDAGE. PLAINTIFF ALLEGES THE ICE PACK LEAKED RESULTING IN A CHEMICAL BURN INJURY TO THE PLAINTIFF'S LEFT LEG.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KWIK KOOL ICE PACK KOOL PACK IMD ALLEGIANCE-SURGICAL GRP UNKKOOLPK UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other