BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MIZUHO OSI

    MDR report key: 4146727 · Received August 5, 2014

    Report

    Report Number
    4146727
    Event Type
    Injury
    Date Received
    August 5, 2014
    Date of Event
    July 16, 2014
    Report Date
    July 29, 2014
    Product Code
    JEA
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    CA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    THIS WAS A (B)(6) Y/O FEMALE SCHEDULED FOR AN ANTERIOR HIP JOINT REPLACEMENT, WITH A HISTORY OF (B)(6), OBESITY, AND DEGENERATION JOINT DISEASE. PT RECEIVED A SPINAL ANESTHESIS IN THE PACU. PT WAS BROUGHT INTO THE OPERATING ROOM BY THE CIRCULATOR RN AND THE ANESTHESIOLOGIST, AND THEN TRANSFERRED TO THE HANA TABLE WITH THE HELP OF THE RESIDENT. THE RESIDENT WAS AT THE LEFT UPPER SIDE OF THE PT. THE RN ANNOUNCED MOVING THE GURNEY OUT OF THE OPERATING ROOM SUITE. THE RESIDENT WALKED DOWN TO SECURE THE LEFT BOOT TO THE SPAR AND PT FELL. PT SUSTAINED A LEFT HUMERAL NECK FRACTURE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    457551 MIZUHO OSI HANA TABLE JEA 6875

    Patients

    Seq Age Sex Outcome Treatment
    1 67 YR Hospitalization