BEUDAMED
    FDA Adverse Event Summary report: N

    PHYSICAL THERAPY TREATMENT TABLE

    MDR report key: 2872331 · Received December 5, 2012

    Report

    Report Number
    2872331
    Date Received
    December 5, 2012
    Date of Event
    November 8, 2012
    Report Date
    November 13, 2012
    Manufacturer
    CHATTANOOGA GROUP, INC.
    Product Code
    INQ
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    NY, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    OUTPATIENT SAT ON PHYSICAL THERAPY TREATMENT TABLE WHEN IT WAS IN THE LOW POSITION. AFTER SHE SAT/LAID DOWN THE TABLE BEGAN TO ELEVATE, AND CONTINUED TO RISE. PATIENT FELL OFF THE TABLE, WAS STABILIZED AND SENT TO THE EMERGENCY DEPARTMENT WHERE SHE WAS TREATED FOR A DISLOCATED SHOULDER AND FRACTURED ARM DUE TO THE FALL. CLINICAL ENGINEERING DEPARTMENT HAS SEQUESTERED THAT IT IS POSSIBLE TO HAVE THE FOOT PEDAL JUST UNDER THE FRAME TO WHERE IF SOMEONE SITS ON THE TABLE IT ACTUATES THE PEDAL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PHYSICAL THERAPY TREATMENT TABLE INQ CHATTANOOGA GROUP, INC. TRT-200

    Patients

    Seq Age Sex Outcome Treatment
    1 67 YR Other| R