BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CHAIRMAN DENTAL CHAIR

    MDR report key: 109323 · Received July 29, 1997

    Report

    Report Number
    1017522-1997-00100
    Event Type
    Malfunction
    Date Received
    July 29, 1997
    Report Date
    July 28, 1997
    Manufacturer
    SIEMENS PELTON & CRANE
    Product Code
    KLC
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    DENTIST

    Narratives

    Description of Event or Problem · 1

    PELTON & CRANE REC'D A CALL FROM THE DR'S OFFICE IN REGARDS TO HIS CHAIRMAN CHAIR BREAKING WHILE LIFTING A VERY LARGE PT. THE DR TOLD THE CO HE WAS LIFTING A 400 PLUS POUND PT IN THE CHAIR WHEN THE LIFT LINKAGE BROKE CAUSING THE PT TO FALL OUT OF THE CHAIR. THERE WERE NO INJURIES REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CHAIRMAN DENTAL CHAIR DENTAL OPERATORY CHAIR KLC SIEMENS PELTON & CRANE L1 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 NA