FDA Adverse Event Other Summary report: N

KWIKTRAK TRACK

MDR report key: 1971713 · Received January 12, 2011

Report

Report Number
9681684-2011-00001
Event Type
Other
Date Received
January 12, 2011
Date of Event
January 1, 2010
Report Date
December 14, 2010
Manufacturer
BHM MEDICAL, INC.
Product Code
FNG
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE MANUFACTURER INFORMED THE INITIAL REPORTER TO CONTACT THE END USER TO IMMEDIATELY STOP USING HIS INSTALLATION UNTIL IT IS REPAIRED. FURTHER INFORMATION WILL BE PROVIDED UPON MANUFACTURER'S INVESTIGATION.

Description of Event or Problem · 1

THE JOINTS OF THE TRACK INSTALLATION ARE OPEN 1/4 INCH. NO INCIDENT OCCURRED, THERE WAS NO PT INVOLVED, AND NO INJURIES WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 KWIKTRAK TRACK NONE FNG BHM MEDICAL, INC. 9100001

Patients

Seq Age Sex Outcome Treatment
1 Other