MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 08 report with the FDA on 1997-01-24 for BENNETT S82RM6 manufactured by Bennett, Subsidiary Of Trex Med..
[43570]
X-ray tubestand mounted on the floor and attached to the wall fell without injury and with equipment damage at dr's office.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 2424102-1997-00001 |
| MDR Report Key | 65269 |
| Report Source | 08 |
| Date Received | 1997-01-24 |
| Date of Report | 1997-01-24 |
| Date of Event | 1996-12-31 |
| Date Mfgr Received | 1996-12-31 |
| Device Manufacturer Date | 1996-10-01 |
| Date Added to Maude | 1997-01-30 |
| 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 |
| Reporter Occupation | SERVICE AND TESTING PERSONNEL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 3 |
| Remedial Action | OT |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | BENNETT S82RM6 |
| Generic Name | WALL/FLOOR MOUNTED TUBESTAND |
| Product Code | ITY |
| Date Received | 1997-01-24 |
| Model Number | S82RM6 |
| Catalog Number | S82RM6 |
| Lot Number | * |
| ID Number | * |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Age | * |
| Device Eval'ed by Mfgr | Y |
| Implant Flag | N |
| Date Removed | A |
| Device Sequence No | 1 |
| Device Event Key | 65365 |
| Manufacturer | BENNETT, SUBSIDIARY OF TREX MED. |
| Manufacturer Address | 445 OAK ST. COPIAGUE NY 11726 US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 1997-01-24 |