BEUDAMED
    FDA Adverse Event Injury Summary report: N

    NI

    MDR report key: 174738 · Received June 29, 1998

    Report

    Report Number
    MW4002280
    Event Type
    Injury
    Date Received
    June 29, 1998
    Date of Event
    January 1, 1965
    Report Date
    June 5, 1998
    Manufacturer
    UNK
    Product Code
    IZO
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    IL, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    "THANKS FOR YOUR RESPONSE TO MY MEDWATCH REPORT. THIS IS INFO I DIDN'T INCLUDE: THE X-RAY MACHINE WAS LOCATED IN A DOWNTOWN OFFICE BUILDNG. I BELIEVE THE CLINIC WAS OPERATED BY THE REQUESTER OF THE X-RAY, AND THE RAILROAD."

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 NI X-RAY MACHINE IZO UNK NI NI

    Patients

    Seq Age Sex Outcome Treatment
    1 54 YR