FDA Adverse Event
Malfunction
Summary report: N
5855 ORTHOPEDIC TABLE TOP
MDR report key: 2243746
·
Received July 29, 2011
Report
- Report Number
- 2921578-2011-00021
- Event Type
- Malfunction
- Date Received
- July 29, 2011
- Date of Event
- July 20, 2011
- Report Date
- July 28, 2011
- Manufacturer
- MIZUHO OSI
- Product Code
- JEA
- Product Problem
- Yes
- Report Source
- Manufacturer report
Narratives
Additional Manufacturer Narrative · 1
DURING A REPAIR OF A 5855 ORTHOPEDIC TABLE TOP, THE TECHNICIAN FOUND THE TABLE SPAR CONNECTING THE TABLE TOP HAD BECOME CRACKED AND SEPARATING FROM THE SPAR MOUNT ASSEMBLY. WILL ADVISE UPON COMPLETION OF INVESTIGATION ((B)(4) 2011).
Description of Event or Problem · 1
DURING A REPAIR OF A 5855 ORTHOPEDIC TABLE TOP, THE TECHNICIAN FOUND THE TABLE SPAR CONNECTING THE TABLE TOP HAD BECOME CRACKED AND SEPARATED FROM THE SPAR MOUNT ASSEMBLY.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | 5855 ORTHOPEDIC TABLE TOP | ORTHOPEDIC OPERATING ROOM TABLE | JEA | MIZUHO OSI | 5855 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |