BEUDAMED
    FDA Adverse Event Other Summary report: N

    ANDREWS TABLE

    MDR report key: 2757361 · Received July 27, 2012

    Report

    Report Number
    2921578-2012-00014
    Event Type
    Other
    Date Received
    July 27, 2012
    Date of Event
    December 22, 2011
    Report Date
    July 24, 2012
    Manufacturer
    MIZUHO OSI
    Product Code
    FQO
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    TABLE AGE IS 20 YEARS, STATUS OF TABLE IS UNK. WILL CONTACT HOSPITAL FOR FURTHER DETAILS AND ADVISE ((B)(4) 2012).

    Description of Event or Problem · 1

    A PT WAS POSITIONED ON THE ANDREWS TABLE, THE TIBIAL SUPPORT LEVER WAS POSITIONED DOWN AND THE MOVEMENT LEVEL WAS PUSHED. ALL FUNCTIONS OF THE TABLE PROCEEDED TO MOVE, THE PT WAS REPOSITIONED AND THE LEVER WAS PUSHED AGAIN. ALL FUNCTIONS OF THE TABLE MOVED, EXCEPT IN A DIFFERENT DIRECTION. PT WAS REMOVED FROM TABLE AND REPOSITIONED ON A JACKSON TABLE AND SURGERY WAS CONTINUED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ANDREWS TABLE OPERATING ROOM TABLE FQO MIZUHO OSI 5820

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK