BEUDAMED
    FDA Adverse Event Other Summary report: N

    BERCHTOLD TELETOM

    MDR report key: 439248 · Received January 17, 2003

    Report

    Report Number
    1220685-2003-00001
    Event Type
    Other
    Date Received
    January 17, 2003
    Date of Event
    December 19, 2002
    Report Date
    January 13, 2003
    Manufacturer
    BERCHTOLD CORP.
    Product Code
    FQO
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MD, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    DURING A SURGICAL PROCEDURE, AN O.R. NURSE WENT TO RE-POSITION A TELETOM (BOOM), WHICH WAS FIVE FEET AWAY FROM THE OPERATING TABLE. WHEN THE BOOM ROTATED TO AN INTERNAL STOP, THE NURSE ATTEMPTED TO FORCEFULLY OVERCOME THE STOP BY EXERTING ADDITIONAL PRESSURE. THE COMBINATION OF LATERAL AND VERTICAL FORCES LIFTED THE EQUIPMENT COLUMNS & SHELVES OFF THE BOOM, CAUSING THEM TO FALL APPROXIMATELY 2 FEET TO THE FLOOR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BERCHTOLD TELETOM GAS & EQUIPMENT COLUMN FQO BERCHTOLD CORP. 700 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 *