MAUDE MDR 4088184

MDR report key
4088184
Report number
3005536974-2014-00003
Event key
0
Event type
3
Date of event
2013-12-13
Date received
2014-09-02
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Contact
ART WAITE
Address
171 CHURCH ST. SUITE 140 CHARLESTON SC 29401 US
Phone
843-843-8439
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1BIONECT CREAM, 25G TUBEHYALURONATE SODIUMINNOCUTISMGQNANA610336/3R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12014-09-0201. O

Event Narratives#

D

Patient 1

THIS SPONTANEOUS EVENT WAS RECEIVED BY PHONE ON (B)(6) 2013. CALLER REPORTS AN ADVERSE REACTION TO THE PRODUCT. CALLER REPORTS APPLYING THE CREAM YESTERDAY MORNING. CALLER REPORTS THAT ABOUT 30 MINUTES AFTER APPLICATION, SHE EXPERIENCED PAIN, A BURNING SENSATION, SWELLING, WATERING EYES AND RUNNY NOSE. CALLER REPORTS THAT SHE APPLIED THE PRODUCT UNDER HER EYES NEAR CHEEKS AND INNER EYE. CALLER REPORTS SHE GENTLY WASHED OFF THE PRODUCT RIGHT AWAY WITH MILD SOAP. CALLER REPORTS THAT SYMPTOMS HAVE IMPROVED, BUT SKIN STILL HAS A BURNING SENSATION AND THERE IS STILL SOME REDNESS. CALLER REPORTS THAT SHE WAS NOT ON ANY OTHER MEDICATIONS WHEN USED. CALLER SEEMED DISTRACTED AND SLOW TO RESPOND AT TIMES. IT WAS EXPLAINED THAT THIS IS NOT AN EXPECTED EFFECT OF USING THE PRODUCT PER LABEL INSTRUCTIONS. IT WAS RECOMMENDED THAT SHE DISCONTINUES USE AND WASH EXPOSED SKIN. SKIN MAY BE TREATED WITH COLD COMPRESS AND VITAMIN E OIL AND ALOE VERA CREAM. IF ANY NEW OR UNEXPECTED SYMPTOMS DEVELOP OR THE SYMPTOMS ARE NOT IMPROVING OR RESOLVING AS DISCUSSED, PLEASE CONTACT (B)(6) AGAIN 24/7 SO THAT WE MIGHT ADVISE ON FURTHER TREATMENT OR DETERMINE IF REFERRAL TO A HEALTHCARE PROFESSIONAL MIGHT BE NEEDED. CALLER WAS GIVEN THE CASE NUMBER.

N

Patient 1

THE INFORMATION CONTAINED IN THIS REPORT IS BASED ON SELF-REPORTED STATEMENTS PROVIDED TO THE MANUFACTURER DURING A TELEPHONE INTERVIEW. THESE SELF-REPORTED DESCRIPTIONS OF AN INCIDENT HAVE NOT BEEN INDEPENDENTLY VERIFIED TO BE FACTUALLY CORRECT OR COMPLETE DESCRIPTIONS OF THE INCIDENT. FOR THAT REASON, INFORMATION CONTAINED IN THIS REPORT DOES NOT AND CAN NOT FORM THE BASIS FOR A DETERMINATION OF WHETHER THE REPORT CLINICAL EFFECTS ARE CAUSALLY RELATED OR ASSOCIATED WITH AN EXPOSURE TO THE PRODUCT IDENTIFIED IN THE TELEPHONE INTERVIEW. THE INFORMATION PROVIDED IN THIS REPORT HAS NOT BEEN MEDICALLY VERIFIED VIA CONFIRMATION WITH THE PATIENT'S PHYSICIANS OR BY THE PROVISION OF PATIENT MEDICAL RECORDS. WHEN CONSIDERING THE BODY OF REGULATORY DATA AND POST-MARKETING DATA AS WELL AS THE WRIGHT OF SCIENTIFIC PEER REVIEWED EVIDENCE ON TOPICALLY APPLIED HYALURONATE CONTAINING PRODUCT SUCH A CAUSAL RELATIONSHIP BETWEEN THE USE OF THIS TYPE OF DEVICE AND THE DEVELOPMENT OF THE ADVERSE EFFECTS REPORTED IN THIS CASE CANNOT BE DEFINITIVELY ESTABLISHED. WHEN EVALUATING A PATIENT FOR A POTENTIAL HYPERSENSITIVITY (ALLERGIC) REACTION, A CLINICAL PRACTITIONER MUST CONSIDER SEVERAL POTENTIAL ENVIRONMENTAL ETIOLOGIES AS WELL AS ANY GOODS, BEVERAGES, MEDICATIONS, OR DIETARY SUPPLEMENTS THE PATIENT HAD BEEN TAKING JUST PRIOR TO THE ONSET OF SYMPTOMS. DEFINITIVE CAUSALITY CANNOT BE APPLIED TO ANY ONE COMPOUND OR AGENT WITHOUT VERIFICATION.