BEUDAMED
    FDA Adverse Event Death Summary report: N

    GEL-ONE INJ 30MG/3ML

    MDR report key: 7702163 · Received July 18, 2018

    Report

    Report Number
    MW5078472
    Event Type
    Death
    Date Received
    July 18, 2018
    Date of Event
    July 7, 2018
    Report Date
    July 13, 2018
    Manufacturer
    SEIKAGAKU CORP., TAKAHAGI PLLANT
    Product Code
    MOZ
    UDI-DI
    87541030091
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    US
    Reporter Occupation
    PHARMACIST

    Narratives

    Description of Event or Problem · 1

    ON (B)(6) 2018, THE PT'S DAUGHTER REPORTED THAT THE PT PASSED AWAY ON (B)(6) 2018. CAUSE OF DEATH UNK. DATES OF USE: 3 MONTHS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    540444 GEL-ONE INJ 30MG/3ML GEL-ONE INJ 30MG/3ML MOZ SEIKAGAKU CORP., TAKAHAGI PLLANT 87541030091

    Patients

    Seq Age Sex Outcome Treatment
    1 92 YR Death