BEUDAMED
    FDA Adverse Event Other Summary report: N

    OVERHEAD COUNTERPOISE SYSTEM

    MDR report key: 290925 · Received August 14, 2000

    Report

    Report Number
    2520313-2000-00007
    Event Type
    Other
    Date Received
    August 14, 2000
    Date of Event
    May 18, 2000
    Report Date
    August 11, 2000
    Manufacturer
    F. WALTER HANEL, GMBH
    Product Code
    DXT
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AS
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    HOSPITAL REPORTED THE HORIZONTAL ARM, VERTICAL ARM AND THE INJECTOR HEAD CAME APART FROM THE CEILING MOUNT OF THE OVERHEAD COUNTERPOISE SYSTEM AND THE SYSTEM FELL. NO INJURY OCCURRED.

    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