BEUDAMED
    FDA Adverse Event Other Summary report: N

    STANDARD 5 LB WEIGHT PACK

    MDR report key: 1183979 · Received October 1, 2008

    Report

    Report Number
    MW5008505
    Event Type
    Other
    Date Received
    October 1, 2008
    Date of Event
    September 1, 2008
    Report Date
    October 1, 2008
    Manufacturer
    PATTERSON MEDICAL/ SAMMON DRESTON
    Product Code
    CCX
    Report Source
    Voluntary report
    Reporter Location
    AL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    A WEIGHT BAG WAS ON THE PT WHEN THE PT ENTERED THE MRI ROOM. THE SCAN BEGAN AND THE WEIGHT BAG FLEW INTO THE MRI. THE PT WAS NOT INJURED. IT WAS DISCOVERED THAT THE STAFF BELIEVED THE BAG WAS FILLED WITH SAND AND NOT METAL SHOT. THE DESCRIPTION ON THE BAG DID NOT INDICATE IT WAS FILLED WITH METAL SHOT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 STANDARD 5 LB WEIGHT PACK WEIGHT BAG CCX PATTERSON MEDICAL/ SAMMON DRESTON

    Patients

    Seq Age Sex Outcome Treatment
    1