BEUDAMED
    FDA Adverse Event Other Summary report: N

    ALM

    MDR report key: 614822 · Received July 27, 2004

    Report

    Report Number
    9710053-2004-00004
    Event Type
    Other
    Date Received
    July 27, 2004
    Report Date
    July 7, 2004
    Manufacturer
    ALM S.A
    Product Code
    FSY
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IL, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    OR SUPERVISOR WAS MOVING A CONTRACTOR INSTALLED LIGHT HEAD WHEN IT BROKE AT THE "ELBOW" AND MADE CONTACT WITH OR SUPERVISORS RIGHT LEG. WHEN OR SUPERVISOR MOVED IN AN ATTEMPT TO GET AWAY FROM THE LIGHT IT WAS DESCRIBED THAT THE OR SUPERVISOR PULLED THEIR NECK. OR SUPERVISOR WAS SENT TO THE ER, RELEASED AND SENT HOME. NO BLEEDING OR LACERATIONS WERE OBSERVED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ALM SURGICAL LIGHT FSY ALM S.A AX10 *

    Patients

    Seq Age Sex Outcome Treatment
    1 *