BEUDAMED
    FDA Adverse Event Other Summary report: N

    ANGIOMAT CT9000 ADV INJECTOR

    MDR report key: 559269 · Received May 6, 2004

    Report

    Report Number
    1518293-2004-00005
    Event Type
    Other
    Date Received
    May 6, 2004
    Date of Event
    April 26, 2004
    Report Date
    May 6, 2004
    Manufacturer
    LIEBEL-FLARSHEIM CO.
    Product Code
    DXT
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    CUSTOMER REPORTS AN UNK AMOUNT OF AIR WAS INJECTED INTO A PT. THE FINAL OUTCOME WAS FAVORABLE AND NO PT INJURY WAS REPORTED. HOSP REPORTS OPERATOR ERROR AS PROBABLE CAUSE FOR INCIDENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ANGIOMAT CT9000 ADV INJECTOR ANGIOGRAPHIC INJECTOR & SYRINGE DXT LIEBEL-FLARSHEIM CO. * *

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other