MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1997-05-21 for LEAD SHIELD * manufactured by Med Corp..
[54326]
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.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | MW1011335 |
| MDR Report Key | 92325 |
| Date Received | 1997-05-21 |
| Date of Report | 1997-05-05 |
| Date of Event | 1997-05-05 |
| Date Added to Maude | 1997-05-23 |
| Event Key | 0 |
| Report Source Code | Voluntary report |
| Manufacturer Link | N |
| 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 | 0 |
| Report to FDA | 0 |
| Event Location | 3 |
| Single Use | 0 |
| Previous Use Code | 0 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | LEAD SHIELD |
| Generic Name | LEAD SHIELD |
| Product Code | IWQ |
| Date Received | 1997-05-21 |
| Model Number | * |
| Catalog Number | * |
| Lot Number | * |
| ID Number | * |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Implant Flag | N |
| Date Removed | * |
| Device Sequence No | 1 |
| Device Event Key | 91198 |
| Manufacturer | MED CORP. |
| Manufacturer Address | 101 N DAYTON PO BOX 50010 AMES IA 50010 US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1997-05-21 |