PRESCRIPTION GLASSES 5975 CL

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-02-05 for PRESCRIPTION GLASSES 5975 CL manufactured by Marchon.

Event Text Entries

[99293567] I had an allergic reaction to my new glasses that were prescribed by my optometrist, dr. (b)(6) in (b)(6). Within a day of wearing the glasses, i developed a painful and itchy rash everywhere the frames touched my skin. The frames were calvin klein 5975 cl. Calvin klein 5975.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5075076
MDR Report Key7244554
Date Received2018-02-05
Date of Report2018-02-03
Date Added to Maude2018-02-06
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationPATIENT
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NamePRESCRIPTION GLASSES
Generic NamePRRECRIPTION GLASSES
Product CodeHQG
Date Received2018-02-05
Model Number5975 CL
OperatorLAY USER/PATIENT
Device AvailabilityN
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerMARCHON


Patients

Patient NumberTreatmentOutcomeDate
101. Deathisabilit 2018-02-05

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