BEUDAMED
    FDA Adverse Event Other Summary report: N

    MEDRAD CT INJECTOR

    MDR report key: 217750 · Received April 1, 1999

    Report

    Report Number
    2520313-1999-00017
    Event Type
    Other
    Date Received
    April 1, 1999
    Date of Event
    March 25, 1999
    Report Date
    April 1, 1999
    Manufacturer
    MEDRAD, INC.
    Product Code
    DXT
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    ND, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    WHILE TECH WAS FILLING SYRINGE, THE NYLON BUSHING AT THE TOP OF PEDESTAL RISER TUBE BROKE. TECH CAUGHT THE HEAD IN HER HANDS. NO ONE INJURED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDRAD CT INJECTOR CT INJECTOR DXT MEDRAD, INC. ECT NA

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Other