MCKESSON 159-22

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a distributor report with the FDA on 2017-11-07 for MCKESSON 159-22 manufactured by Sunmed Llc..

Event Text Entries

[91261401] The customer alleges that "the patient got a scratched cornea from the eye protector. " the affected device was not returned, no lot number was provided and no description of the incident. The product is designed to protect a patient's eyes during a procedure and if used properly, no part of the product comes close to the patient's eyes so it is highly unlikely that it could cause an injury.
Patient Sequence No: 1, Text Type: N, H10


[91261402] The customer alleges that "the patient got a scratched cornea from the eye protector. " no other details were provided.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1036445-2017-00001
MDR Report Key7007411
Report SourceDISTRIBUTOR
Date Received2017-11-07
Date of Report2017-10-13
Date Added to Maude2017-11-07
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 ContactMS. CARRIE FORTUNA
Manufacturer Street2710 NORTHRIDGE DR. SUITE A
Manufacturer CityGRAND RAPIDS MI 49544
Manufacturer CountryUS
Manufacturer Postal49544
Manufacturer Phone6162598400
Manufacturer G1SUNMED LLC.
Manufacturer Street2710 NORTHRIDGE DR. SUITE A
Manufacturer CityGRAND RAPIDS MI 49544
Manufacturer CountryUS
Manufacturer Postal Code49544
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameMCKESSON
Generic NameEYE PROTECTOR
Product CodeHOY
Date Received2017-11-07
Model Number159-22
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerSUNMED LLC.
Manufacturer Address2710 NORTHRIDGE DR. SUITE A GRAND RAPIDS MI 49544 US 49544


Patients

Patient NumberTreatmentOutcomeDate
10 2017-11-07

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