BEUDAMED
    FDA Adverse Event Injury Summary report: N

    OSI

    MDR report key: 1202324 · Received October 16, 2008

    Report

    Report Number
    MW5008632
    Event Type
    Injury
    Date Received
    October 16, 2008
    Date of Event
    October 14, 2008
    Report Date
    October 16, 2008
    Manufacturer
    MIZUHOSI
    Product Code
    FQO
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    AR, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PT WAS POSITIONED ON TABLE AND ASLEEP FROM ANESTHESIA AND ANTICOAGULATED FOR OR PROCEDURE TO BEGIN, BUTTON PUSHED TO LOWER TABLE AND TABLE DUMPED PT SIDEWAYS ONTO FLOOR. DATES OF USE; 2007-2008. DIAGNOSIS OR REASON FOR USE: TABLE IS ABLE FOR USE WITH C-ARM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 OSI OR TABLE FQO MIZUHOSI OSI 5803

    Patients

    Seq Age Sex Outcome Treatment
    1 75 YR Hospitalization| S