MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-07-28 for LIFESTYLES NOT PROVIDED AT TIME OF REPORT manufactured by Not Provided At Time Of Report.
[81314243]
On 07/28/2017 - as of this date, no information available to specific product subject to the complaint and thus no lot code or manufacturer identity can be established.
Patient Sequence No: 1, Text Type: N, H10
[81314244]
On (b)(6) 2017 customer contacted that they used a lifestyles natural rubber latex condom and they contracted a sti.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1019632-2017-00011 |
| MDR Report Key | 6750650 |
| Date Received | 2017-07-28 |
| Date of Report | 2017-09-07 |
| Date of Event | 2017-07-27 |
| Date Facility Aware | 2017-07-27 |
| Report Date | 2017-07-28 |
| Date Reported to FDA | 2017-07-28 |
| Date Added to Maude | 2017-07-28 |
| 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 | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | LIFESTYLES |
| Generic Name | NATURAL RUBBER LATEX CONDOM |
| Product Code | HIS |
| Date Received | 2017-07-28 |
| Model Number | NOT PROVIDED AT TIME OF REPORT |
| Operator | LAY USER/PATIENT |
| Device Availability | N |
| Device Age | DA |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | NOT PROVIDED AT TIME OF REPORT |
| Manufacturer Address | US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2017-07-28 |