BEUDAMED
    FDA Adverse Event Other Summary report: N

    OVERHEAD COUNTERPOISE SYSTEM

    MDR report key: 211426 · Received February 19, 1999

    Report

    Report Number
    2520313-1999-00005
    Event Type
    Other
    Date Received
    February 19, 1999
    Date of Event
    January 12, 1999
    Report Date
    February 19, 1999
    Manufacturer
    F. WALTER HANEL GMBH
    Product Code
    DXT
    Report Source
    Manufacturer report
    Reporter Location
    MA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    REFERENCE ATTACHED FORM 3500 REPORTED BY UNIVERSITY OF MASSACHUSETTS MEMORIAL HEALTH SYSTEMS. "ONE OF THE ARMS FELL OFF OF THE CENTER POST. THE TECHNOLOGIST WAS POSITIONING THE INJECTOR MOUNTED ON THE ARM AT THAT TIME. THE ARM HIT HIS SHOULDER AND CAME TO REST AT THE BOTTOM OF THE TABLE. THE TABLE WAS EXTENDED TOWARDS THE HEAD END, KEEPING THE PT OUT OF THE WAY."

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 OVERHEAD COUNTERPOISE SYSTEM OVERHEAD COUNTERPOISE SYSTEM DXT F. WALTER HANEL GMBH OCS115 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Other