KERAMATRIX NDC 71474-303-05 UNK

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-11-25 for KERAMATRIX NDC 71474-303-05 UNK manufactured by Molecular Biologicals, Llc.

Event Text Entries

[168059363] New squamous cell cancer noted at site of previous melanoma excision and after use of topical products and graft. Fda safety report id# (b)(4).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5091281
MDR Report Key9376164
Date Received2019-11-25
Date of Report2019-11-22
Date of Event2019-10-09
Date Added to Maude2019-11-26
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag0
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Sequence Number: 1

Brand NameKERAMATRIX
Generic NameDRESSING, WOUND, DRUG
Product CodeFRO
Date Received2019-11-25
Model NumberNDC 71474-303-05
Catalog NumberUNK
Lot NumberEXP 122019
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Sequence No1
Device Event Key0
ManufacturerMOLECULAR BIOLOGICALS, LLC

Device Sequence Number: 2

Brand NameKERAGEL
Generic NameDRESSING, WOUND, DRUG
Product CodeFRO
Date Received2019-11-25
Model NumberNDC 71474-303-05
Lot NumberEXP 122019
Device Availability*
Device Sequence No2
Device Event Key0
ManufacturerMOLECULAR BIOLOGICALS, LLC


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2019-11-25

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