inforMED
MalfunctionIOY

SUPPORT ARM 176

Received Nov 2, 2021 · Event occurred Oct 20, 2021

Report 8010042-2021-02629 · MDR key 12735628

Device

Generic name

Support, Arm

Model number

SUPPORT ARM 176

Catalog number

6405976

Product problems

  • Fracture
  • Fracture

Patient

Not reported

  • No Clinical Signs, Symptoms or Conditions
  • No Clinical Signs, Symptoms or Conditions

Narrative

Additional Manufacturer Narrative

NO SERVICE WAS REQUESTED. THE SUPPORT ARM WAS REPLACED BY THE USER FACILITY AND NOT RETURNED FOR INVESTIGATION. NO PICTURES ON THE DAMAGES WERE PROVIDED. THE ROOT CAUSE OF THE BROKEN SUPPORT ARM HAS NOT BEEN CONCLUSIVELY DETERMINED BUT MOST LIKELY HAS IT BEEN EXPOSED TO A MECHANICAL FORCE GREATER THAN IT IS DESIGNED TO SUSTAIN.

Description of Event or Problem

IT WAS REPORTED THAT THE SUPPORT ARM HOLDING THE PATIENT CIRCUIT BROKE. THERE WAS NO PATIENT HARM. MANUFACTURER'S REF #: (B)(4).