BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MEDRAD

    MDR report key: 1719496 · Received June 8, 2010

    Report

    Report Number
    MW5016279
    Event Type
    Malfunction
    Date Received
    June 8, 2010
    Date of Event
    May 11, 2010
    Report Date
    May 13, 2010
    Manufacturer
    MEDRAD, INC.
    Product Code
    DXT
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    IL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    MEDRAD TUBING CRACKED CAUSING CONTRAST MEDIA TO SPILL ON CT TABLE AND FLOOR. NOT USED ON PATIENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDRAD STELLANT STERILE DISPOSABLE SYRINGE DXT MEDRAD, INC. 100529

    Patients

    Seq Age Sex Outcome Treatment
    1