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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT DIAGNOSTICS SCARBOROUGH, INC BINAXNOW COVID-19 ANTIGEN SELF TEST; LATERAL FLOW IMMUNOASSAY IVD OF COVID-19

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ABBOTT DIAGNOSTICS SCARBOROUGH, INC BINAXNOW COVID-19 ANTIGEN SELF TEST; LATERAL FLOW IMMUNOASSAY IVD OF COVID-19 Back to Search Results
Catalog Number 195-160
Device Problem Use of Device Problem (1670)
Patient Problems Blurred Vision (2137); Burning Sensation (2146)
Event Date 12/09/2021
Event Type  malfunction  
Manufacturer Narrative
The investigation is still in progress.A supplemental report will be provided after completion.
 
Event Description
The user reported snapping off a cap that was part of a binaxnow covid-19 reagent covid self-test kit and squirted the contents into their right eye.A few minutes after the exposure, they flushed the eye with water multiple times.They reported experiencing watery eye.
 
Manufacturer Narrative
This supplemental report is being submitted to provide the investigation conclusion.Chemtrec provided the safety data sheet to the customer and no further action is required.Based on the above summary, the investigation is deemed complete.The product will continue to be monitored and tracked.
 
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Brand Name
BINAXNOW COVID-19 ANTIGEN SELF TEST
Type of Device
LATERAL FLOW IMMUNOASSAY IVD OF COVID-19
Manufacturer (Section D)
ABBOTT DIAGNOSTICS SCARBOROUGH, INC
10 southgate road
scarborough ME 04074
Manufacturer Contact
kindra sudduth
10 southgate road
scarborough, ME 04074
6613888803
MDR Report Key13257029
MDR Text Key283824566
Report Number1221359-2022-00276
Device Sequence Number1
Product Code QKP
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
EUA210264
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Consumer
Reporter Occupation Other
Type of Report Initial,Followup
Report Date 05/05/2022
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Lay User/Patient
Device Catalogue Number195-160
Is the Reporter a Health Professional? No
Initial Date Manufacturer Received 12/15/2021
Initial Date FDA Received01/14/2022
Supplement Dates Manufacturer Received04/21/2022
Supplement Dates FDA Received05/06/2022
Was Device Evaluated by Manufacturer? No
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Other;
Patient SexFemale
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