BEUDAMED
    FDA Adverse Event Other Summary report: N

    *

    MDR report key: 305639 · Received November 17, 2000

    Report

    Report Number
    305639
    Event Type
    Other
    Date Received
    November 17, 2000
    Date of Event
    October 4, 2000
    Report Date
    November 5, 2000
    Manufacturer
    INFIMED, INC.
    Product Code
    JAA
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    VIDEO MONITOR FOR FLOUROSCOPY MOUNTED ON PIECE OF EQUIP. (ARM FROM CEILING) - TO BE ALLOWED TO SWIVEL. NO SUPPORT FOR MONITOR FROM BOTTOM. WEIGHT OF MONITOR HANGS FROM BRACKET MOUNTED ONTO TOP ONLY. TECH WAS SWIVELING MONITOR TO SEE SCREEN. PT LYING ON TABLE, BELOW. MONITOR BROKE FROM BRACKET, WAS FALLING, TECH TRIED TO CATCH IT TO KEEP IT FROM INJURING PT, HIT THE TECH IN THE FOREHEAD, HIT THE PT ON THE RIGHT ARM ABOVE ELBOW - ONLY INJURY - SMALL BRUISE - SORENESS TO PT. TECH - SMALL LACERATION, BRUISE, HEADACHE.

    Description of Event or Problem · 2

    VIDOE MONITOR FOR FLUROSCOPY MOUNTED ON PIECE OF EQUIP. (ARM FROM CEILING)- TO BE ALLOWED TO SWIVEL. NO SUPPORT FOR MONITOR FROM BOTTOM. WEIGHT OF MONITOR HANGS FROM BRACKET MOUNTED ONTO TOP ONLY. TECH WAS SWIVELING MONITOR TO SEE SCREEN. PT LYING ON TABLE BELOW. MONITOR BROKE FROM BRACKET, WAS FALLING, TECH TRIED TO CATCH IT TO KEEP IT FROM INJURING PT, HIT THE TECH IN THE FOREHEAD, HIT THE PT ON THE RIGHT ARM ABOVE ELBOW-ONLY INJURY-SMALL BRUISE-SORENESS TO PT. TECH-SMALL LACERATION, BRUISE, HEADACHE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * * JAA INFIMED, INC. * *

    Patients

    Seq Age Sex Outcome Treatment
    1 50 YR Other
    2 UNKNOWN Other