BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SINGLE CEILING MOUNT

    MDR report key: 111873 · Received August 6, 1997

    Report

    Report Number
    2018492-1997-00009
    Event Type
    Malfunction
    Date Received
    August 6, 1997
    Date of Event
    July 2, 1997
    Report Date
    August 6, 1997
    Manufacturer
    BURTON MEDICAL PRODUCTS CORP.
    Product Code
    FSY
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    WHILE THE DOCTOR WAS EXAMINING A PT, THE LIGHT FIXTURE FELL FROM THE CEILING MOUNT. THE LIGHT WAS CAUGHT BEFORE HITTING THE PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SINGLE CEILING MOUNT CEILING MOUNT FSY BURTON MEDICAL PRODUCTS CORP. 0100540 UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN