FDA Adverse Event Malfunction Summary report: N

ADVANCED CONTROL I-BASE, DC

MDR report key: 19919952 · Received August 6, 2024

Report

Report Number
2921578-2024-00012
Event Type
Malfunction
Date Received
August 6, 2024
Date of Event
April 2, 2024
Report Date
October 22, 2024
Manufacturer
MIZUHO ORTHOPEDIC SYSTEMS, INC.
Product Code
JEA
UDI-DI
00842430106026
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
BIOMEDICAL ENGINEER
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

PER THE INFORMATION OBTAINED FROM DEVICE EVALUATION, IT WAS FOUND OUT THAT THE TABLE HAD ONE LOOSE CASTER, DC POWER CONNECTIVITY PROBLEMS AND SLIGHT RUST OBSERVED ON THE CENTER BEAM. THESE ISSUES WERE FIXED BY MIZUHO OSI SERVICE ENGINEER. THE REASON FOR THE TABLE TILT REMAINS UNCLEAR AS THERE WAS NO EVIDENCE FOUND THAT INDICATED ANY ISSUE WITH THE TILT MECHANISM OF THE TABLE. IT WAS ALSO FOUND OUT THAT THE DEVICE WAS LAST SERVICED BY MIZUHO OSI IN 2019 AND WAS CURRENTLY BEING SUBJECTED TO SERVICE AND MAINTENANCE PROCESS BY A THIRD PARTY (NON-MIZUHO OSI) ESTABLISHMENT. THERE IS ALSO NO EVIDENCE THAT INDICATES THE FREQUENCY OF MAINTENANCE BY THE USER. THE ROOT CAUSE FOR THIS INCIDENT IS THUS DEEMED AS LACK OF PREVENTIVE MAINTENANCE BY THE USER.

Description of Event or Problem · 0

PATIENT WAS ON OR BED, AND BED UNEXPECTEDLY MOVED, LEFT SIDE TILTED DOWN. STAFF WAS ABLE TO PREVENT THE PATIENT FROM FALLING, NO HARM TO PATIENT.

Description of Event or Problem · 0

PATIENT WAS ON OR BED, AND BED UNEXPECTEDLY MOVED, LEFT SIDE TILTED DOWN. STAFF WAS ABLE TO PREVENT THE PATIENT FROM FALLING, NO HARM TO PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1673866 ADVANCED CONTROL I-BASE, DC OPERATING TABLE JEA MIZUHO ORTHOPEDIC SYSTEMS, INC. 5803 00842430106026

Patients

Seq Age Sex Outcome Treatment
1 NA Male