BEUDAMED
    FDA Adverse Event Injury Summary report: N

    TOSHIBA

    MDR report key: 2123255 · Received June 14, 2011

    Report

    Report Number
    2020563-2011-00011
    Event Type
    Injury
    Date Received
    June 14, 2011
    Date of Event
    May 13, 2011
    Report Date
    May 17, 2011
    Manufacturer
    TOSHIBA MEDICAL SYSTEMS CORPORATION
    Product Code
    JAK
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CO, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    THE TECHNOLOGIST HAD A MINOR ABRASION TO THE CORNEA FROM THE PIECE THAT ALLEGEDLY BROKE OFF FROM THE COVER. SHE WENT TO THE HOSPITAL'S OCCUPATIONAL HEALTH DEPARTMENT AND HER EYE WAS EXAMINED AND CLEANED. SHE WAS NOT GIVEN ANY TYPE OF MEDICATION AND WAS TOLD IF SHE HAD ANY PAIN TO TAKE SOME TYLENOL. SHE IS BACK AT WORK. THE BROKEN COVER WAS REPLACED. THE CLIPBOARD BEING CAUGHT BETWEEN THE MOVING PORTION AND COVER ON THE FOOT OF THE TABLE WAS ALLEGEDLY THE CAUSE OF THE COVER BREAKING. THE PIECE FROM THE BROKEN COVER ALLEGEDLY WAS THE CAUSE OF THE EYE ABRASION.

    Description of Event or Problem · 1

    TABLE WAS MOVED TOWARD FOOT END AND A HOSPITAL CLIPBOARD LEFT ON THE TABLE INADVERTENTLY BECAME CAUGHT BETWEEN THE MOVING PORTION AND COVER ON THE FOOT END OF THE TABLE. AS A RESULT, THE COVER BROKE AND THE TECHNOLOGIST WAS ALLEGEDLY HIT IN THE EYE BY A BROKEN PIECE OF THE COVER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TOSHIBA COMPUTED TOMOGRAPHY X-RAY SYSTEM JAK TOSHIBA MEDICAL SYSTEMS CORPORATION TSX-101A

    Patients

    Seq Age Sex Outcome Treatment
    1 Other