MEDICAL ACTION INDUSTRIES 71133

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-02-07 for MEDICAL ACTION INDUSTRIES 71133 manufactured by Medical Action Industries, Inc..

Event Text Entries

[135371922] I used this item to prep the patients skin with and then noticed that he had scratches on his arm and 3 streaks where the skin was broken. The 3 scratches were up to 8 cm long and redness area was up to 14 cm long. The skin was broken and there was some blood, but a very scant amount. I called dr into the room for her to look at what happened. No photos were taken.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number8314547
MDR Report Key8314547
Date Received2019-02-07
Date of Report2019-01-02
Date of Event2018-12-31
Report Date2019-01-02
Date Reported to FDA2019-01-02
Date Reported to Mfgr2019-02-07
Date Added to Maude2019-02-07
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag0
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameMEDICAL ACTION INDUSTRIES
Generic NameI.V. START KIT
Product CodeLRS
Date Received2019-02-07
Model Number71133
Catalog Number71133
Lot Number251204
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerMEDICAL ACTION INDUSTRIES, INC.
Manufacturer Address25 HEYWOOD RD. ARDEN NC 28704 US 28704


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2019-02-07

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