BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    RUSCH

    MDR report key: 375275 · Received January 31, 2002

    Report

    Report Number
    2429473-2002-00020
    Event Type
    Malfunction
    Date Received
    January 31, 2002
    Report Date
    January 29, 2002
    Manufacturer
    RUSCH, INC.
    Product Code
    FAX
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    THE CUSTOMER REPORTS THAT THE SPIRAL FILFORM WAS STRIPPED INSIDE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 RUSCH SPIRAL FILFORM FAX RUSCH, INC. NA 105872

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN