FDA Adverse Event Other Summary report: N

OVERHEAD COUNTERPOISE SYSTEM

MDR report key: 209108 · Received February 5, 1999

Report

Report Number
2520313-1999-00008
Event Type
Other
Date Received
February 5, 1999
Date of Event
December 29, 1998
Report Date
February 5, 1999
Manufacturer
F. WALTER HANEL GMGH
Product Code
DXT
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

THE OVERHEAD COUNTERPOISE SYSTEM (OCS) BROKE ALLOWING THE ARM AND THE INJECTOR HEAD TO DROP. NO INJURY OCCURRED.

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