BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CHAMPION MFG

    MDR report key: 703857 · Received April 24, 2006

    Report

    Report Number
    1834066-2006-00001
    Event Type
    Injury
    Date Received
    April 24, 2006
    Date of Event
    January 17, 2006
    Report Date
    April 18, 2006
    Manufacturer
    CHAMPION MFG. INC.
    Product Code
    FIA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    NO INFORMATION

    Narratives

    Description of Event or Problem · 1

    THE LETTER FROM AN ATTORNEY ALLEGES THE CONSUMER'S LEGS FLIPPED OFF THE CHAIR AND HIT A BOLT, CAUSING A HEMATOMA THAT REQUIRED SURGERY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CHAMPION MFG 880.6140 FIA CHAMPION MFG. INC. 54 SERIES NA

    Patients

    Seq Age Sex Outcome Treatment
    1 * Required Intervention