BEUDAMED
    FDA Adverse Event Other Summary report: N

    WASHER STERILIZER

    MDR report key: 44590 · Received October 7, 1996

    Report

    Report Number
    2515984-1996-90001
    Event Type
    Other
    Date Received
    October 7, 1996
    Date of Event
    September 30, 1996
    Report Date
    October 4, 1996
    Manufacturer
    AMERICAN STERILIZER CO.
    Product Code
    FLE
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    SOAP EJECTOR WAS CLOGGED. INSTEAD OF WATER FLOWING THROUGH EJECTOR SIPHONING DETERGENT FROM CONTAINER, THE WATER FLOWED INTO THE SOAP CONTAINER AND OVERFLOWED SPILLING SOAPY WATER ONTO THE FLOOR. OPERATOR SLIPPED ON FLOOR BRUISING RIGHT ELBOW AND HIP. ALSO HIT HEAD ON FLOOR. THIS WAS A MINOR INJURY, BUT COULD HAVE BEEN A SERIOUS INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 WASHER STERILIZER RELIANCE 3400 WASHER STERILIZER FLE AMERICAN STERILIZER CO. 3400 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other