BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    OUTPATIENT PLUS SINGLE CEILING MOUNT

    MDR report key: 906695 · Received August 23, 2004

    Report

    Report Number
    2018492-2004-00013
    Event Type
    Malfunction
    Date Received
    August 23, 2004
    Date of Event
    August 8, 2004
    Report Date
    August 13, 2004
    Manufacturer
    BURTON MEDICAL PRODUCTS CORP.
    Product Code
    FSY
    Removal / Correction Number
    2-589-715
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IA, US
    Reporter Occupation
    BIOMEDICAL ENGINEER

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 OUTPATIENT PLUS SINGLE CEILING MOUNT CEILING MOUNT FSY BURTON MEDICAL PRODUCTS CORP. 0124522 1966

    Patients

    Seq Age Sex Outcome Treatment
    1 NA