ILLUSION GLOVE STRAWBERRY 112-4991

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 99 report with the FDA on 2010-12-01 for ILLUSION GLOVE STRAWBERRY 112-4991 manufactured by Oon Corp Resources.

Event Text Entries

[18236392] The office alleges four staff members between the ages 26-60 experienced a rash after using latex examination gloves. One person went to the dermatologist for a pre-existing condition and not because of the gloves. The other three staff members did not seek any medical attention.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2411236-2010-00005
MDR Report Key1916090
Report Source99
Date Received2010-12-01
Date of Report2010-11-02
Date of Event2010-11-02
Date Facility Aware2010-11-02
Report Date2010-12-01
Date Reported to FDA2010-12-01
Date Reported to Mfgr2010-12-01
Date Added to Maude2011-11-02
Event Key0
Report Source CodeDistributor report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationDENTIST
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameILLUSION GLOVE STRAWBERRY
Generic NameLATEX EXAMINATION GLOVES
Product CodeLYY
Date Received2010-12-01
Catalog Number112-4991
Lot Number510070
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeNA
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerOON CORP RESOURCES
Manufacturer AddressKHUSUS MY


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2010-12-01

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