BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PATIENT SCALE

    MDR report key: 24895 · Received August 15, 1994

    Report

    Report Number
    1219590-1994-09001
    Event Type
    Injury
    Date Received
    August 15, 1994
    Date of Event
    June 14, 1994
    Report Date
    July 20, 1994
    Manufacturer
    SR. INSTRUMENTS, INC.
    Product Code
    FRW
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    IL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    SCREW THAT PREVENTS THE SCALE FROM COMING OFF MOUNTING ATTACHMENT BROKE WHILE USER WAS BEING WEIGHTED. USER ALLEGEDLY FELL SUSTAINING LACERATION THAT REQUIRED MEDICAL TREATMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PATIENT SCALE PATIENT SCALE FRW SR. INSTRUMENTS, INC. 9833

    Patients

    Seq Age Sex Outcome Treatment
    1 * Required Intervention