MAUDE Adverse Event Report: 3M COMPANY MICROPORE-PAPER TAPE 2 X 10 YDS; TAPE AND BANDAGE, ADHESIVE

Patient Problems Hypersensitivity/Allergic reaction (1907); Rash (2033)

Event Type  Injury  

Event Description

Complaint: a registered nurse reported to fresenius medical care that a patient experienced rash after using micropore-paper tape 2 x 10 yds.The patient was advised by the registered nurse to discontinue use and was given different tape from facility to use.Dr.(b)(6) was notified of allergy.Allergies were updated in ecc.This report reflects information received by fda in the form of a notification per 803.22 (b)(2).

• Brand Name: MICROPORE-PAPER TAPE 2 X 10 YDS
• Type of Device: TAPE AND BANDAGE, ADHESIVE
• Manufacturer (Section D): 3M COMPANY
• MDR Report Key: 19116980
• MDR Text Key: 340493722
• Report Number: MW5153893
• Device Sequence Number: 1
• Product Code: KGX
• Combination Product (y/n): N
• Reporter Country Code: US
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Voluntary
• Reporter Occupation: Other
• Type of Report: Initial
• Report Date: 04/12/2024

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
• Initial Date Manufacturer Received: Not provided
• Initial Date FDA Received: 04/15/2024
• Patient Sequence Number: 1