BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ALLEN STIRRUPS (SAM I)

    MDR report key: 111777 · Received August 8, 1997

    Report

    Report Number
    111777
    Event Type
    Malfunction
    Date Received
    August 8, 1997
    Date of Event
    August 5, 1997
    Report Date
    August 7, 1997
    Manufacturer
    ALLEN MEDICAL SYSTEMS
    Product Code
    EYD
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    FL, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT IN SURGERY. ALLEN STIRRUPS BEING UTILIZED. LEFT LEG FELL DOWN IN STIRRUP FOR NO REASON, WITH NO ONE TOUCHING STIRRUP OR PT, WHILE PT ANESTHETIZED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ALLEN STIRRUPS (SAM I) PT LEG SUPPORT-OPERATING ROOM EYD ALLEN MEDICAL SYSTEMS SAM I - 0017 *

    Patients

    Seq Age Sex Outcome Treatment
    1 42 YR