inforMED
InjuryHMT

CUSTOM PAK

Received Oct 10, 2008 · Event occurred Sep 8, 2008

Report 1644019-2008-00030 · MDR key 1196365

Device

Generic name

Convenience Kit

Manufacturer

Alcon-houston

Model number

CUSTOM PAK

Catalog number

CUSTOM PAK

Lot number

814471H

Product problems

  • Sticking

Patient

Not reported

  • Skin Tears

Narrative

Description of Event or Problem

THE NURSE REPORTED THAT THE DRAPE THEY NORMALLY GET WAS TEMPORARILY CHANGED IN THEIR PACK, AND WHEN REMOVING THE DRAPE AT THE END OF THE PROCEDURE TODAY, SOME OF THE PT'S FACIAL SKIN WAS ADHERED TO THE STICKY PART OF THE DRAPE AND RIPPED A LARGE AMOUNT OF THE PT'S FACIAL SKIN. SHE IS GOING TO REQUIRE ADDITIONAL TREATMENT.

Additional Manufacturer Narrative

INVESTIGATION INCLUDING ROOT CAUSE ANALYSIS IS IN PROGRESS. A SUPPLEMENTAL MDR WILL BE FILED AS NECESSARY WHEN ADDITIONAL REPORTABLE INFO BECOMES AVAILABLE. THIS REPORT WAS MAILED TO FDA ON: 10/10/2008.