BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    *

    MDR report key: 1642078 · Received March 2, 2010

    Report

    Report Number
    1642078
    Event Type
    Malfunction
    Date Received
    March 2, 2010
    Date of Event
    July 31, 2009
    Report Date
    March 2, 2010
    Manufacturer
    GCX CORPORATION
    Product Code
    MHX
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    MO, US

    Narratives

    Description of Event or Problem · 1

    PATIENT MONITOR BROKE OFF ITS MOUNT ADAPTER ON THE GCX ROLLING MONITOR STAND. THE MOUNT BROKE ON THE STAND, CAUSING THE MONITOR TO FALL. THE MONITOR WAS DAMAGED AS A RESULT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * STAND, MOBILE, PHYSIOLOGICAL MONITOR MHX GCX CORPORATION * *

    Patients

    Seq Age Sex Outcome Treatment
    1 *