BEUDAMED
    FDA Adverse Event Injury Summary report: N

    X-RAY EQUIPMENT

    MDR report key: 78708 · Received March 26, 1997

    Report

    Report Number
    MW1011044
    Event Type
    Injury
    Date Received
    March 26, 1997
    Date of Event
    July 1, 1993
    Report Date
    March 18, 1997
    Manufacturer
    NI
    Product Code
    IZO
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    IN, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    RPTR CLAIMS THEY SUFFERED EXCESSIVE IRRADIATION; BURNS, OTHER SKIN PROBLEMS, WITHDRAWAL, AND DEPRESSION AS A RESULT OF AN X-RAY EXAMINATION FOR TMJ. RPTR STATES "AN ATTEMPT WAS MADE TO ENROLL ME IN THEIR FAMILY CARE CLINIC USING FLATTERY. I AM A MEDICAID PARTICIPANT. I BELIEVE DISCRIMINATION, FRAUD, MISREPRESENTATION AND ABUSE OCCURRED. I ALSO BELIEVE THE EQUIPMENT IS FAULTY."

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 X-RAY EQUIPMENT X-RAY EQUIPMENT IZO NI NI NI

    Patients

    Seq Age Sex Outcome Treatment
    1 53 YR Hospitalization| L TYLENOL