BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    LITHOTRON

    MDR report key: 2222055 · Received August 18, 2011

    Report

    Report Number
    MW5021821
    Event Type
    Malfunction
    Date Received
    August 18, 2011
    Date of Event
    May 4, 2011
    Report Date
    August 18, 2011
    Manufacturer
    NA
    Product Code
    LNS
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    IL, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    PT ON TABLE 1/3 OF THE WAY THROUGH PROCEDURE AND TABLE CEASED TO MOVE CONNECTION CHECKED BY TECH STILL UNABLE TO MOVE TABLE. PROCEDURE STOPPED. NO ADVERSE PT OUTCOME.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LITHOTRON LITHOTRON LNS NA 0931

    Patients

    Seq Age Sex Outcome Treatment
    1 40 YR Other