FDA Adverse Event
Malfunction
Summary report: N
HIR-200
MDR report key: 430778
·
Received November 26, 2002
Report
- Report Number
- 1221261-2002-00086
- Event Type
- Malfunction
- Date Received
- November 26, 2002
- Report Date
- November 15, 2002
- Manufacturer
- LEVEL 1, INC.
- Product Code
- KZD
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- WI, US
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
HOSPITAL ALLEGES THAT THE FRONT DOOR CAME FLYING OFF OF HIR-200 PRODUCT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | HIR-200 | * | KZD | LEVEL 1, INC. | HIR-200 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NO INFO | Other |