FDA Adverse Event Injury Summary report: N

ADVANTX LCA

MDR report key: 2589914 · Received May 23, 2012

Report

Report Number
9611343-2012-00019
Event Type
Injury
Date Received
May 23, 2012
Report Date
May 9, 2012
Manufacturer
GE MEDICAL SYSTEMS SCS
Product Code
IZI
PMA / PMN Number
K945375
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

PT DATA AND INCIDENT DATE REQUESTED BUT THE HOSPITAL HAS NOT PROVIDED THEM.

Description of Event or Problem · 1

IT WAS REPORTED THAT A TECHNOLOGIST TRIPPED AND FELL AS A RESULT OF GETTING HIS/HER FOOT TANGLED IN CABLES BUNDLED UNDER THE TABLE OF THE SYSTEM. THE FALL RESULTED IN A BROKEN RIB AND PATELLA. GE HEALTHCARE'S INVESTIGATION IS ONGOING. A FOLLOW UP REPORT WILL BE SUBMITTED ONCE THE INVESTIGATION HAS BEEN COMPLETED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ADVANTX LCA ANGIOGRAPHIC X-RAY SYSTEM IZI GE MEDICAL SYSTEMS SCS

Patients

Seq Age Sex Outcome Treatment
1 Other