BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BURKHART ROENTGEN, INC.

    MDR report key: 91555 · Received August 15, 1994

    Report

    Report Number
    91555
    Event Type
    Malfunction
    Date Received
    August 15, 1994
    Date of Event
    March 18, 1994
    Report Date
    March 24, 1994
    Manufacturer
    BURKHART ROENTGEN, INC.
    Product Code
    IWQ
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    PA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    THE X-RAY SHIELD SUSPENDED ABOVE TABLE FELL AT TEH FOOT OF THE TABLE. PT WAS NOT INJURED. THE SHIELD FELL AS IT WAS BEING MOVED. WELD BROKE AT THE BASE OF THE POST.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BURKHART ROENTGEN, INC. X-RAY SHIELD IWQ BURKHART ROENTGEN, INC. * *

    Patients

    Seq Age Sex Outcome Treatment
    1 * Other