inforMED
InjuryKPW

SUMMIT COLLIMATOR

Received Jun 17, 2014 · Event occurred Jun 5, 2014

Report 3929691 · MDR key 3929691

Device

Generic name

D800 Collimator

Manufacturer

Summit Industries

Model number

D800

Catalog number

MATCH 200

Product problems

  • Detachment of Device or Device Component

Patient

Not reported

  • Injury

Narrative

Description of Event or Problem

FACILITY INFORMED US (SERVICE PROVIDER) THAT THE COLLIMATOR CAME LOOSE AND FELL STRIKING A PT IN THE LEG WHILE ON THE X-RAY TABLE. WE REPAIRED COLLIMATOR FOR FURTHER USE. CONDITION OF PT IS UNK. WE (SERVICE PROVIDER), WERE CALLED IN TO COME FIX THE ISSUE WHEN WE WERE TOLD ABOUT THE COLLIMATOR STRIKING A PT. WE WERE NOT THE CURRENT SERVICE PROVIDER OF THE MEDICAL X-RAY EQUIPMENT. OUR SERVICE ENGINEER REMEMBERED THE RECALL FROM 2007 AND REPAIRED ACCORDING TO THE RECALL INSTRUCTIONS. ORIGINAL RECALL DATED 8/3/2007. THIS REPORT PROVIDED BY: (B)(6). (B)(4).