TAPE MICROPORE PAPER SURG 1" X 10 YD

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2020-03-17 for TAPE MICROPORE PAPER SURG 1" X 10 YD manufactured by 3m Company.

Event Text Entries

[184275832] Indication - selective deficiency of immunoglobulin a [iga]. Pt mom requested a wrap to send since the tape affects the skin of her child. Tylenol needed as well. No further info provided. Reported to cvs/caremark by pt/caregiver. Dose or amount: 1"x 10yd, frequency: as needed, route: topical. Dates of use: (b)(6) 2020 to current.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5093823
MDR Report Key9848153
Date Received2020-03-17
Date of Report2020-03-06
Date Added to Maude2020-03-18
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
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 NameTAPE MICROPORE PAPER SURG 1" X 10 YD
Generic NameTAPE AND BANDAGE, ADHESIVE
Product CodeKGX
Date Received2020-03-17
Device Availability*
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
Manufacturer3M COMPANY


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-17

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