BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNIVERSAL

    MDR report key: 371326 · Received January 10, 2002

    Report

    Report Number
    1418964-2002-00001
    Event Type
    Injury
    Date Received
    January 10, 2002
    Date of Event
    January 3, 2002
    Report Date
    January 10, 2002
    Manufacturer
    DEL MEDICAL IMAGING
    Product Code
    IYB
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    TUBESTAND ROLLED OFF OF ITS FLOOR TRACK ALLOWING IT TO FALL TOWARDS THE FLOOR. STOP BRACKETS ON FLOOR TRACK WERE NOT IN PLACE AT THE TIME OF THIS INCIDENT. TECHNOLOGIST RECEIVED A FRACTURED HAND AND A BRUISED FOOT. NO PATIENT WAS INVOLVED IN THIS INCIDENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 UNIVERSAL TUBESTAND IYB DEL MEDICAL IMAGING 3306A T 12/86

    Patients

    Seq Age Sex Outcome Treatment
    1 * Required Intervention