WALGREEN'S * 8206-671818

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1996-12-03 for WALGREEN'S * 8206-671818 manufactured by Faichney Med Co..

Event Text Entries

[36044] Retailer's insurance agent reported that one of the retailer's customers alleged that when she opened the thermometer case, the thermometer was broken and mercury spilled on three of her rings.
Patient Sequence No: 1, Text Type: D, B5

MAUDE Entry Details

• Report Number: 1933255-1996-00002
• MDR Report Key: 54243
• Date Received: 1996-12-03
• Date of Report: 1996-12-02
• Date of Event: 1996-11-05
• Date Facility Aware: 1996-11-12
• Report Date: 1996-12-02
• Date Reported to FDA: 1996-12-02
• Date Reported to Mfgr: 1996-12-03
• Date Added to Maude: 1996-12-10
• Event Key: 0
• Report Source Code: Distributor report
• Manufacturer Link: N
• Number of Patients in Event: 0
• Adverse Event Flag: 3
• Product Problem Flag: 3
• Reprocessed and Reused Flag: 0
• Health Professional: 3
• Initial Report to FDA: 3
• Report to FDA: 3
• Event Location: 3
• Single Use: 0
• Previous Use Code: 0
• Event Type: 3
• Type of Report: 3

Device Details

• Brand Name: WALGREEN'S
• Generic Name: BASAL THERMOMETER
• Product Code: FLK
• Date Received: 1996-12-03
• Model Number: *
• Catalog Number: 8206-671818
• Lot Number: *
• ID Number: *
• Operator: LAY USER/PATIENT
• Device Availability: N
• Device Age: UNKNOWN
• Implant Flag: N
• Date Removed: A
• Device Sequence No: 1
• Device Event Key: 54812
• Manufacturer: FAICHNEY MED CO.
• Manufacturer Address: 17159 SURREY VIEW DR CHESTERFIELD MO 63005 US

Patients

Patient Number	Treatment	Outcome	Date
1	0		1996-12-03