BEUDAMED
    FDA Adverse Event Injury Summary report: N

    TOSHIBA AQUILON 64 CT SCANNER TABLE

    MDR report key: 2396798 · Received December 29, 2011

    Report

    Report Number
    MW5023660
    Event Type
    Injury
    Date Received
    December 29, 2011
    Date of Event
    December 16, 2011
    Report Date
    December 20, 2011
    Manufacturer
    TOSHIBA MEDICAL SYSTEMS
    Product Code
    JAK
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MS, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PT WAS LAID ON THE (B)(4) TABLE. PT'S ARM GOT CAUGHT IN THE TABLE AS IT WAS MOVING IN TO SCAN PT'S HEAD. PT SCREAMED THAT HER ARM WAS CAUGHT. TECHNOLOGIST IMMEDIATELY CHECKED TO SEE WHAT WAS WRONG WITH THE PT. IT CAUGHT HER ARM IN THE TABLE, BUT DIDN'T BREAK THE SKIN OR BRUISE THE AREA WHERE IT WAS CAUGHT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TOSHIBA AQUILON 64 CT SCANNER TABLE CT TABLE JAK TOSHIBA MEDICAL SYSTEMS TSX101A/DL

    Patients

    Seq Age Sex Outcome Treatment
    1 39 YR Required Intervention