BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SIEMENS

    MDR report key: 295129 · Received September 8, 2000

    Report

    Report Number
    MW1019874
    Event Type
    Malfunction
    Date Received
    September 8, 2000
    Date of Event
    August 24, 2000
    Report Date
    August 29, 2000
    Manufacturer
    SIEMENS MEDICAL SYS, INC.
    Product Code
    IZO
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NM, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    TABLE TOP MOVED BY SELF AND PINNED TECH AGAINST WALL BUCKY. FOUND SWITCH 551B MECHANICALLY STUCK CAUSING TABLE TO DRIVE. 0RDERED AND REPLACED SWITCH PART # INSTALLED 1041292.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SIEMENS X-RAY MACHINE IZO SIEMENS MEDICAL SYS, INC. TRIDORO 712MP *

    Patients

    Seq Age Sex Outcome Treatment
    1 43 YR Other