BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MORGAN BASIC ONE

    MDR report key: 11824633 · Received May 14, 2021

    Report

    Report Number
    11824633
    Event Type
    Malfunction
    Date Received
    May 14, 2021
    Date of Event
    February 24, 2021
    Report Date
    May 10, 2021
    Manufacturer
    MORGAN MEDESIGN, INC.
    Product Code
    KXJ
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    KS
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    STAFF BROUGHT (B)(6) CENTER PATIENT INTO PROCEDURE ROOM AND INSTRUCTED PATIENT HOW TO GET ON SURGICAL TABLE. THE TABLE COLLAPSED TO THE FLOOR WITH THE PATIENT IN/ON IT. PATIENT REPORTED HE WAS "FINE". PATIENT CALLED HOSPITAL LATER REGARDING LEFT SHOULDER SORENESS WITH BRUISE AND NECK PAIN THAT HE NOTED AFTER FALL/COLLAPSE OF SURGICAL TABLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    724479 MORGAN BASIC ONE TABLE, RADIOLOGIC KXJ MORGAN MEDESIGN, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 23360 DA Other