BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SUPPORT ARM 177

    MDR report key: 1732952 · Received June 17, 2010

    Report

    Report Number
    8010042-2010-00125
    Event Type
    Malfunction
    Date Received
    June 17, 2010
    Date of Event
    June 1, 2010
    Report Date
    June 9, 2010
    Manufacturer
    MAQUET CRITICAL CARE AB
    Product Code
    IOY
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OK, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4).

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE SUPPORT ARM BROKE DURING ADJUSTMENT. (B)(4). (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SUPPORT ARM 177 IOY MAQUET CRITICAL CARE AB

    Patients

    Seq Age Sex Outcome Treatment
    1