BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MIDMARK

    MDR report key: 2464068 · Received February 15, 2012

    Report

    Report Number
    1523530-2012-00004
    Event Type
    Malfunction
    Date Received
    February 15, 2012
    Date of Event
    January 23, 2012
    Report Date
    February 15, 2012
    Manufacturer
    MIDMARK CORP.
    Product Code
    FQO
    PMA / PMN Number
    EXEMPT
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MD, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    THE PRODUCT HAS NOT BEEN RETURNED AT THIS TIME. AN INVESTIGATION WILL BE CONDUCTED WHEN THE PRODUCT IS RETURNED.

    Description of Event or Problem · 1

    THE FACILITY STAFF CLAIMS THE TABLE CONTINUED TO RUN, BACK AND BASE UP, AFTER THE CONTROL WAS RELEASED. NO INJURIES WERE REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MIDMARK EXAMINATION TABLE FQO MIDMARK CORP. 630-003

    Patients

    Seq Age Sex Outcome Treatment
    1