BEUDAMED
    FDA Adverse Event Other Summary report: N

    ATLAS 60" TRANSFER CARRIAGE

    MDR report key: 1277403 · Received November 11, 2008

    Report

    Report Number
    2515984-2008-00014
    Event Type
    Other
    Date Received
    November 11, 2008
    Date of Event
    September 25, 2008
    Report Date
    November 11, 2008
    Manufacturer
    STERIS MEXICO S. DE R.L. DE C.V.
    Product Code
    FLE
    PMA / PMN Number
    NA
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    NO INFORMATION

    Narratives

    Additional Manufacturer Narrative · 1

    A STERIS TECHNICIAN VISITED THE HOSPITAL AND EXAMINED THE TRANSFER CART. THE CART WAS IN GOOD CONDITION AND DID NOT REQUIRE REPAIR. THE INSTRUMENT TRAY HAD NO SHARP EDGES, BUT WAS AN OLDER MODEL THAT HAD ROOM BETWEEN THE TRAY HANDLE AND THE MOUNTING BLOCK. THE HOSPITAL STAFF REPORTED THAT THE TRANSFER CART BECAME STUCK AND IT WAS PUSHED FROM THE SIDE RATHER THAN FROM THE TOP AS RECOMMENDED, RESULTING IN THE INSTRUMENT TRAY SHIFTING POSITION ON THE CART. IN THE PROCESS, THE EMPLOYEE'S FINGER SLIPPED BETWEEN THE HANDLE OF THE INSTRUMENT TRAY HANDLE AND THE MOUNTING BLOCK AND THEN STRUCK THE POST OF THE TRANSFER CART, RESULTING IN A CUT OF THE OPERATOR'S FINGER.

    Description of Event or Problem · 1

    THE USER FACILITY REPORTS THE EMPLOYEE IS NO LONGER WORKING FOR THE FACILITY BUT IS WORKING FOR ANOTHER HOSPITAL AND IS PERFORMING THE SAME JOB DUTIES.

    Description of Event or Problem · 1

    AN OPERATOR CUT HER FINGER WHILE MOVING LOADED INSTRUMENT TRAYS FROM ATLAS TRANSFER CART INTO A STEAM STERILIZER. THE TRANSFER CART IS USED TO MOVE INSTRUMENT TRAYS TO AND FROM WASHING AND STERILIZATION EQUIPMENT. IT WAS REPORTED THAT THE OPERATOR WENT TO THE HOSPITAL'S EMERGENCY ROOM FOR TREATMENT OF THE CUT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ATLAS 60" TRANSFER CARRIAGE TRANSFER CARRIAGE FLE STERIS MEXICO S. DE R.L. DE C.V. 4011084 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention