FDA Adverse Event Summary report: N

*

MDR report key: 1131363 · Received August 11, 2008

Report

Report Number
1131363
Date Received
August 11, 2008
Date of Event
July 22, 2008
Report Date
August 11, 2008
Manufacturer
DEROYAL INDUSTRIES
Product Code
FSY
Report Source
User Facility report
Reporter Location
RI, US
Reporter Occupation
RISK MANAGER

Narratives

Description of Event or Problem · 1

THE DISPOSABLE LIGHT HANDLE FELL FROM THE LIGHT ONTO THE STERILE FIELD AT SITE OF THE SURGICAL INCISION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 * HANDLE, SURGICAL LIGHT FSY DEROYAL INDUSTRIES 26-012 *

Patients

Seq Age Sex Outcome Treatment
1 57 YR