MINNCARE HD 78401-202

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer,health professional, report with the FDA on 2017-08-21 for MINNCARE HD 78401-202 manufactured by Medivators, Inc..

Event Text Entries

[83193092] A facility reported that an employee was exposed to minncare hd disinfectant underneath their eye after the container slipped and solution bounced up towards their face. It was reported that the affected personnel rinsed her eye in the facility's eye wash station for the full recommended time and did not experience lasting symptoms nor seek additional medical attention. The safety data sheet was obtained by the facility for treatment instructions. The affected personnel was reported to be wearing full ppe, including protective eyewear. This complaint will continue to be monitored in medivators complaint system.
Patient Sequence No: 1, Text Type: N, H10


[83193093] A facility reported an employee experienced chemical exposure of minncare hd underneath their eye. It was reported that the employee rinsed their eye for the full recommended time and sds was obtained by the facility.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2150060-2017-00035
MDR Report Key6808915
Report SourceCONSUMER,HEALTH PROFESSIONAL,
Date Received2017-08-21
Date of Report2017-08-21
Date of Event2017-07-26
Date Mfgr Received2017-07-26
Date Added to Maude2017-08-21
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactALEX NELSON
Manufacturer Street14605 28TH AVE N
Manufacturer CityMINNEAPOLIS MN 55447
Manufacturer CountryUS
Manufacturer Postal55447
Manufacturer Phone7635094799
Manufacturer G1MEDIVATORS, INC.
Manufacturer Street14605 28TH AVE N
Manufacturer CityMINNEAPOLIS MN 55447
Manufacturer CountryUS
Manufacturer Postal Code55447
Single Use3
Remedial ActionNO
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameMINNCARE HD
Generic NameDISINFECTANT
Product CodeNIH
Date Received2017-08-21
Model Number78401-202
OperatorNURSE
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerMEDIVATORS, INC.
Manufacturer Address14605 28TH AVE N MINNEAPOLIS MN 55447 US 55447


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2017-08-21

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