BEUDAMED
    FDA Adverse Event Other Summary report: N

    VALUPAK SHOECOVERS, NON-COND

    MDR report key: 291409 · Received August 18, 2000

    Report

    Report Number
    1423507-2000-00212
    Event Type
    Other
    Date Received
    August 18, 2000
    Date of Event
    August 18, 1997
    Report Date
    August 18, 2000
    Manufacturer
    ALLEGIANCE HEALTHCARE CORP.
    Product Code
    FXP
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NC, US
    Reporter Occupation
    ATTORNEY

    Narratives

    Description of Event or Problem · 1

    PLAINTIFF, WHILE WEARING SHOE COVERS, LOST TRACTION SLIPPED AND FELL IN THE GOWNING ROOM ADJACENT TO THE OPERATING ROOM AT THE HOSP. NO SPECIFIC INJURIES ARE DESCRIBED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 VALUPAK SHOECOVERS, NON-COND VALUPAK SHOECOVERS, NON-COND FXP ALLEGIANCE HEALTHCARE CORP. 4831 UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other