BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    JACKSON

    MDR report key: 1352047 · Received March 12, 2009

    Report

    Report Number
    1352047
    Event Type
    Malfunction
    Date Received
    March 12, 2009
    Date of Event
    March 11, 2009
    Report Date
    March 12, 2009
    Manufacturer
    MIZUHO OSI
    Product Code
    JEB
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    MO, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    DURING SURGERY TO REPAIR A FEMUR FRACTURE THE PATIENT WAS ON THE JACKSON ORTHOPEDIC TABLE AND THE TRACTION UNIT BROKE ALLOWING THE PATIENT TO SLIDE OFF OF THE TABLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 JACKSON TRACTION UNIT JEB MIZUHO OSI * *

    Patients

    Seq Age Sex Outcome Treatment
    1 17 YR