BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    AMSCO

    MDR report key: 2708837 · Received August 15, 2012

    Report

    Report Number
    2708837
    Event Type
    Malfunction
    Date Received
    August 15, 2012
    Date of Event
    August 7, 2012
    Report Date
    August 15, 2012
    Manufacturer
    STERIS
    Product Code
    FQO
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    AZ, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PT IN C-SPINE PRECAUTIONS. WHEN TRANSFERRING PT FROM ACUTE CARE UNIT BED TO OR TABLE; THE OR TABLE LOWER END MOVED APROX 1FOOT WITH PT HALF WAY ON THE OR TABLE. I CHECKED THE OR TABLE BEFORE THE PT HAD ARRIVED IN OR FOR CORRECT FUNCTIONING AND LOCKED IN PLACE. WHEN THE OR TABLE MOVED THE BED INDICATOR LIGHT SAID THE BRAKES WERE ON. PT WAS THEN TRANSFERED BACK TO INPT BED AND A NEW OR TABLE WAS PUT IN THE OR SUITE. AGAIN, NEW OR TABLE CHECKED AND LOCKED BEFORE PT TRANSFERRED. CHARGE RN NOTIFIED AS WELL AS EQUIPMENT TECH.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 AMSCO OR TABLE FQO STERIS 3080L *

    Patients

    Seq Age Sex Outcome Treatment
    1 43 YR