BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CHAIRMAN DENTAL CHAIR

    MDR report key: 131372 · Received November 5, 1997

    Report

    Report Number
    1017522-1997-00126
    Event Type
    Malfunction
    Date Received
    November 5, 1997
    Report Date
    November 5, 1997
    Manufacturer
    SIEMENS PELTON & CRANE
    Product Code
    KLC
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AR, US
    Reporter Occupation
    SERVICE PERSONNEL

    Narratives

    Description of Event or Problem · 1

    PELTON & CRANE REC'D A CALL FROM A DIST SVC TECHNICIAN REGARDING A CHAIRMAN DENTAL CHAIR THAT BROKE. THE TECHNICIAN TOLD CO THAT THE DR HAD A PT IN THE CHAIRMAN CHAIR AND THE PT PUSHED WITH HIS FEET AGAINST THE FLOOR CAUSING THE SEAT ASSEMBLY TO DETACH FROM THE BASE OF THE CHAIR. THE DR CAUGHT THE PT BEFORE HE FELL. THERE WERE NO INJURIES REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CHAIRMAN DENTAL CHAIR DENTAL OPERATORY CHAIR KLC SIEMENS PELTON & CRANE L1 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 NA