BEUDAMED
    FDA Adverse Event Summary report: N

    DIRECT SHIELDED DOOR

    MDR report key: 28198 · Received October 11, 1995

    Report

    Report Number
    MW4000920
    Date Received
    October 11, 1995
    Date of Event
    May 2, 1995
    Report Date
    May 17, 1995
    Manufacturer
    PPB, INC.
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    AZ, US
    Reporter Occupation
    PHYSICIST

    Narratives

    Description of Event or Problem · 1

    DOOR JAMMED IN PARTIALLY-OPEN POSITION. PT IN ROOM AND RPTR WAS NOT ABLE TO FREE PT UNTIL JACK OBTAINED TO PRY DOOR OPEN. LATER IT WAS DETERMINED THAT WHEEL HAD BROKEN AND JAMMED ON DOOR PLATE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DIRECT SHIELDED DOOR DIRECT SHIELDED DOOR PPB, INC. CC21

    Patients

    Seq Age Sex Outcome Treatment
    1 *