BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    TREADMILL

    MDR report key: 16926 · Received October 18, 1994

    Report

    Report Number
    MW1003716
    Event Type
    Malfunction
    Date Received
    October 18, 1994
    Date of Event
    October 6, 1994
    Report Date
    October 7, 1994
    Manufacturer
    QUINTON INSTRUMENT CO.
    Product Code
    IOL
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    WA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PT WAS IN FOR TREADMILL EKG. AFTER 6 MINUTE TEST TECHNICIAN PRESSED "STOP TEST". THE DECK LOWERED, BUT BELT SPED UP. REACHED 11.6 MPH IMMEDIATELY. TECH PRESSED STOP BELT SWITCH TO STOP. PT WAS SAFELY PULLED FROM MOVING MACHINE BY DR. NO INJURY. MFR TO SEND REP TO CHECK DEVICE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TREADMILL IOL QUINTON INSTRUMENT CO. Q55

    Patients

    Seq Age Sex Outcome Treatment
    1 * Other