BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    LEAD SHIELD

    MDR report key: 92325 · Received May 21, 1997

    Report

    Report Number
    MW1011335
    Event Type
    Malfunction
    Date Received
    May 21, 1997
    Date of Event
    May 5, 1997
    Report Date
    May 5, 1997
    Manufacturer
    MED CORP.
    Product Code
    IWQ
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    OH, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    CEILING MOUNTED LEAD SHIELD SUPPORT ARM CRACKED & SEPARATED FROM BASE. ENTIRE UNIT FELL TO THE FLOOR CAUSING DAMAGE TO THE UNIT AS WELL AS STRUCTURAL DAMAGE TO THE TILE & CONCRETE FLOOR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LEAD SHIELD LEAD SHIELD IWQ MED CORP. * *

    Patients

    Seq Age Sex Outcome Treatment
    1 *