FDA Adverse Event
Other
Summary report: N
OVERHEAD COUNTERPOISE SYSTEM
MDR report key: 199164
·
Received November 23, 1998
Report
- Report Number
- 2520313-1998-00052
- Event Type
- Other
- Date Received
- November 23, 1998
- Date of Event
- October 26, 1998
- Report Date
- November 11, 1998
- Manufacturer
- F. WALTER HANEL, GMGH
- Product Code
- DXT
- Removal / Correction Number
- NA
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA, US
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
CUSTOMER REPORTED THE HORIZONTAL ARM BROKE AT FRONT END. NO ONE WAS INJURED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | OVERHEAD COUNTERPOISE SYSTEM | OVERHEAD COUNTERPOISE SYSTEM | DXT | F. WALTER HANEL, GMGH | OCS115 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Other |