BEUDAMED
    FDA Adverse Event Other Summary report: N

    ANGENIEUX

    MDR report key: 362539 · Received November 20, 2001

    Report

    Report Number
    3019090-2001-00005
    Event Type
    Other
    Date Received
    November 20, 2001
    Date of Event
    November 5, 2001
    Manufacturer
    ALM
    Product Code
    FSY
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    THE O.R. TECHNICIAN WAS ADJUSTING THE POSITION OF THE LIGHT WHEN THE EVENT OCCURRED. THE LIGHT HEAD FELL OUT OF IT'S MOUNT IN THE ARM, HIT THE TECHNICIAN ON THE HEAD AND LEFT SHOULDER; AND CAUSED THE TECHNICIAN TO FALL TO THE FLOOR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    52653 ANGENIEUX SURGICAL LIGHT FSY ALM AX-10 DUEL FREE MOTION ARM NA

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other