BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ILLUSION PF BUBBLE GUM GLOVE

    MDR report key: 965750 · Received December 12, 2007

    Report

    Report Number
    2411236-2007-22518
    Event Type
    Injury
    Date Received
    December 12, 2007
    Date of Event
    November 13, 2007
    Report Date
    November 13, 2007
    Manufacturer
    PURNABINA SDN BHD
    Product Code
    LYY
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    CA, US
    Reporter Occupation
    DENTIST

    Narratives

    Description of Event or Problem · 1

    DOCTOR HAD A REACTION WHEN USING LATEX GLOVES THAT REQUIRED HER TO GO TO THE HOSPITAL. SHE EXPERIENCED DIFFICULTY BREATHING AND VERY WATERY EYES WITH NO TYPE OF RASH. THE HOSPITAL ADMINISTERED AN ANTIHISTAMINE SHOT AND HER SYMPTOMS SUBSIDED AND SHE WAS RELEASED THE SAME DAY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ILLUSION PF BUBBLE GUM GLOVE LATEX POWDER FREE EXAMINATION GLOVES LYY PURNABINA SDN BHD * 070741B

    Patients

    Seq Age Sex Outcome Treatment
    1 * Hospitalization