BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MAQUET SERVO I SIEMENS

    MDR report key: 2061310 · Received April 12, 2011

    Report

    Report Number
    MW5020257
    Event Type
    Injury
    Date Received
    April 12, 2011
    Date of Event
    March 30, 2011
    Report Date
    April 12, 2011
    Manufacturer
    SIEMENS
    Product Code
    CBK
    Report Source
    Voluntary report
    Reporter Location
    DC, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    MRI VENTILATOR WAS MOVED ACROSS A FLOOR SAFETY ZONE (200 GAUSS MARKER) AND FLEW INTO THE MRI SCANNER. LUCKILY, THERE WAS NO PT IN THE SCANNER AT THIS TIME. DEVICE: SIEMENS MAQUET, SERVO I, SERIAL # (B)(4). ALSO SEE (B)(4). DIAGNOSIS OR REASON FOR USE: ROUTINE MRI IN SEDATED PTS. EVENT REAPPEARED AFTER REINTRODUCTION? NO.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MAQUET SERVO I SIEMENS NONE CBK SIEMENS

    Patients

    Seq Age Sex Outcome Treatment
    1 Disability