BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    VHM ARM SUSPENSION WALL MOUNT

    MDR report key: 819058 · Received February 12, 2007

    Report

    Report Number
    MW1041922
    Event Type
    Malfunction
    Date Received
    February 12, 2007
    Date of Event
    January 3, 2007
    Report Date
    February 12, 2007
    Manufacturer
    GCX CORPORATION
    Product Code
    DRT
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    THROUGH EXTENDED USE ON HANGING ARM, STRESS FRACTURE NOTED IN THE CORNER OF THE SUPPORT BRACKET OF THE TWO PIECE ASSEMBLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 VHM ARM SUSPENSION WALL MOUNT SUPPORT BRACKET OF THE MOUNTING PLATE ASSEMBLY DRT GCX CORPORATION VHM *

    Patients

    Seq Age Sex Outcome Treatment
    1 *