MAUDE MDR 1199183

MDR report key
1199183
Report number
3004115000-2008-00019
Event key
0
Event type
3
Date of event
2008-09-18
Date received
2008-10-17
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
116
Health professional
3
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Contact
MRS. MARI LAMBERT
Address
901 W. OAKTON STREET DES PLAINES IL 60018 US
Phone
847-847-8473
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1ORTHORALIX SD II PANORAMIC X-RAY SYSTEMDENTAL X-RAY EQUIPMENTGENDEX DENTAL SYSTEMSEAPSD 2N/AR N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12008-10-170

Event Narratives#

D

Patient 1

THE OVERHEAD OF THE PANORAMIC X-RAY UNIT DID NOT STOP WHEN LOWERED, AND LANDED ON THE PATIENT'S SHOULDERS.

N

Patient 1

THE PATIENT DID NOT NEED MEDICAL ATTENTION WITH THIS INCIDENT.THE OVERHEAD OF THE PANORAMIC X-RAY UNIT DID NOT STOP WHEN LOWERED.UNIT WILL BE RETURNED TO MANUFACTURER FOR FURTHER EVALUATION. FOLLOW-UP REPORT WILL BE SUBMITTED ONCE EVALUATION IS COMPLETED.