BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    VARIAN MEDICAL

    MDR report key: 221281 · Received April 21, 1999

    Report

    Report Number
    MW1016213
    Event Type
    Malfunction
    Date Received
    April 21, 1999
    Date of Event
    February 23, 1999
    Report Date
    April 19, 1999
    Manufacturer
    VARIAN ASSOC., INC.
    Product Code
    IYE
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    OR, US
    Reporter Occupation
    PHYSICIST

    Narratives

    Description of Event or Problem · 1

    THE ACCESSORY MOUNT GUIDE PIN FELL OUT OF WEDGE MOUNT, LANDING ON FLOOR. NO ONE WAS IN THE ROOM AT THE TIME, NO-ONE WAS INJURED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 VARIAN MEDICAL LINEAR ACCELERATOR - MEDICAL IYE VARIAN ASSOC., INC. 2100 CD *

    Patients

    Seq Age Sex Outcome Treatment
    1 *