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