BEUDAMED
    FDA Adverse Event Summary report: N

    BURKHARDT RADIATION SHIELD

    MDR report key: 48914 · Received October 10, 1996

    Report

    Report Number
    1217116-1996-00001
    Date Received
    October 10, 1996
    Date of Event
    October 2, 1996
    Report Date
    October 10, 1996
    Manufacturer
    BURKHARDT ROENTGEN INTL, INC.
    Product Code
    IWQ
    Report Source
    Distributor report
    Reporter Location
    NY, US
    Reporter Occupation
    RADIOLOGIC TECHNOLOGIST

    Narratives

    Description of Event or Problem · 1

    AS TECHNOLOGIST WAS REPORTEDLY MOVING THE LEAD SHIELD ASSEMBLY, WHICH WAS SUSPENDED FROM A CEILING POST, THE ASSEMBLY ALLEGEDLY FELL FROM THE CEILING POST SUPPOSEDLY STRIKING THE TECHNOLOGIST'S LEFT FOREARM AND RIGHT FINGER REPORTEDLY RESULTING IN ABRASIONS ON THE LEFT FOREARM AND RIGHT FINGER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BURKHARDT RADIATION SHIELD RADIATION SHIELD IWQ BURKHARDT ROENTGEN INTL, INC. 13.2100493225 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 40 YR