BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    PHILLIPS MEDICAL SYSTEMS -CLEV- INC. FORMERLY PICKER INTERNA

    MDR report key: 418789 · Received September 23, 2002

    Report

    Report Number
    MW1026249
    Event Type
    Malfunction
    Date Received
    September 23, 2002
    Report Date
    September 23, 2002
    Manufacturer
    PHILLIPS MEDICA SYSTEMS -CLEV- INC.
    Product Code
    KXJ
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    THE PT WAS RECEIVING A BARIUM ENEMA AND SUSTAINED FRACTURES OF THE 4TH AND 5TH FINGERS OF THE LEFT HAND AS THE TABLE WAS MOVING DOWN. THE PT WAS EXAMINED IN THE WALK-IN CLINIC, A METAL SPLINT PLACED, TYLENOL GIVEN AND REFERRED TO ER FOR DIAGNOSIS AND TREATMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PHILLIPS MEDICAL SYSTEMS -CLEV- INC. FORMERLY PICKER INTERNA X-RAY EXAM TABLE KXJ PHILLIPS MEDICA SYSTEMS -CLEV- INC. VTX 650 *

    Patients

    Seq Age Sex Outcome Treatment
    1 52 YR Other