BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MOBILE STAND

    MDR report key: 177181 · Received July 10, 1998

    Report

    Report Number
    1030184-1998-00005
    Event Type
    Malfunction
    Date Received
    July 10, 1998
    Date of Event
    June 10, 1998
    Report Date
    June 10, 1998
    Manufacturer
    CRITIKON, DIV OF ETHICON, INC.
    Product Code
    DXN
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TN, US
    Reporter Occupation
    BIOMEDICAL ENGINEER

    Narratives

    Description of Event or Problem · 1

    POWER CORD WAS SEVERED AFTER BEING CAUGHT BETWEEN THE METAL POLE AND BASE. THE END-USER PLUGGED THE DAMAGED/SEVERED CORD INTO AC POWER OUTLET AND NOTED SPARKS AT THE METAL BASE. CARBON DEPOSIT OR RESIDUE WAS NOTED ON THE BASE AFTER THE SPARKS WERE OBSERVED. NO PT OR USER IMPACT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MOBILE STAND MOBILE STAND DXN CRITIKON, DIV OF ETHICON, INC. NA NA

    Patients

    Seq Age Sex Outcome Treatment
    1 NA