MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 00 report with the FDA on 2001-09-26 for TRAUMEX 80000GB * manufactured by Fischer Imaging Corp.
[231759]
Chain broke and caused the assembly to fall down.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1418957-2001-00007 |
| MDR Report Key | 354282 |
| Report Source | 00 |
| Date Received | 2001-09-26 |
| Date of Report | 2001-09-20 |
| Date of Event | 2001-08-23 |
| Date Mfgr Received | 2001-08-30 |
| Device Manufacturer Date | 1991-10-01 |
| Date Added to Maude | 2001-10-04 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 0 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 0 |
| Manufacturer Contact | BILL ABBOUD |
| Manufacturer Street | 12300 N. GRANT DRIVE |
| Manufacturer City | DENVER CO 80241 |
| Manufacturer Country | US |
| Manufacturer Postal | 80241 |
| Manufacturer Phone | 3034526800 |
| Manufacturer G1 | * |
| Manufacturer Street | * |
| Manufacturer City | * |
| Manufacturer Country | * |
| Single Use | 3 |
| Remedial Action | OT |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | TRAUMEX 80000GB |
| Generic Name | * |
| Product Code | IYB |
| Date Received | 2001-09-26 |
| Model Number | 80000GB |
| Catalog Number | * |
| Lot Number | * |
| ID Number | * |
| Operator | OTHER |
| Device Availability | Y |
| Device Eval'ed by Mfgr | Y |
| Implant Flag | N |
| Date Removed | * |
| Device Sequence No | 1 |
| Device Event Key | 343502 |
| Manufacturer | FISCHER IMAGING CORP |
| Manufacturer Address | 12300 N. GRANT ST DENVER CO 802413120 US |
| Baseline Brand Name | TRAUMEX |
| Baseline Generic Name | RAGIOGRAPHIC SYSTEM |
| Baseline Model No | 80000GB |
| Baseline Catalog No | NA |
| Baseline ID | NA |
| Baseline Device Family | TRAUMEX |
| Baseline Shelf Life [Months] | NA |
| Baseline PMA Flag | N |
| Baseline 510K PMN | Y |
| Premarket Notification | K880530 |
| Baseline Preamendment | N |
| Baseline Transitional | N |
| 510k Exempt | N |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2001-09-26 |