BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    31" OFFSET DOUBLE CLAMP BAR

    MDR report key: 57197 · Received September 24, 1996

    Report

    Report Number
    1035617-1996-00008
    Event Type
    Malfunction
    Date Received
    September 24, 1996
    Date of Event
    August 24, 1996
    Report Date
    September 19, 1996
    Manufacturer
    ZIMMER PATIENT CARE DIVISION
    Product Code
    ILZ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PART OF OVERHEAD TRAPEZE REPORTEDLY FELL ONTO PT'S CHEST WHILE IN USE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 31" OFFSET DOUBLE CLAMP BAR TRAPEZE-DOUBLE CLAMP BAR ILZ ZIMMER PATIENT CARE DIVISION NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 69 YR Other