FDA Adverse Event Injury Summary report: N

DISPOSA-VIEW

MDR report key: 3167409 · Received June 11, 2013

Report

Report Number
1718887-2013-00002
Event Type
Injury
Date Received
June 11, 2013
Date of Event
May 1, 2013
Report Date
May 20, 2013
Manufacturer
VITAL SIGNS COLORADO, INC.
Product Code
CCX
PMA / PMN Number
EXEMPT
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FI
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

UNDER EUROPEAN LAW, PT INFORMATION IS CONSIDERED CONFIDENTIAL AND WILL NOT BE RELEASED BY THE SITE. THE EXACT DATE OF THE REPORTED EVENT IS UNK. GE HEALTHCARE'S INVESTIGATION IS ONGOING. A FOLLOW-UP REPORT WILL BE SUBMITTED ONCE THE INVESTIGATION HAS BEEN COMPLETED.

Description of Event or Problem · 1

THE HOSPITAL REPORTED THAT A PT EXPERIENCED UNSPECIFIED "PRESSURE WOUNDS" ON THE CHEEK AND CHIN DURING A PROCEDURE THAT INVOLVED A HEAD POSITIONER. NO FURTHER EVENT OR PT INFORMATION PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
264152 DISPOSA-VIEW HEAD POSITIONERS CCX VITAL SIGNS COLORADO, INC. 8000HDP 20100310

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention