BEUDAMED
    FDA Adverse Event Other Summary report: N

    5890 FIXED JACKSON TABLE BASE

    MDR report key: 476010 · Received July 29, 2003

    Report

    Report Number
    2921578-2003-00002
    Event Type
    Other
    Date Received
    July 29, 2003
    Report Date
    July 18, 2003
    Manufacturer
    ORTHOPEDIC SYSTEMS, INC.
    Product Code
    BWN
    Report Source
    Manufacturer report
    Reporter Location
    MO, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PT PLACED IN A SUPINE POSITION ON THE FRACTURE TABLE, AND THEIR ARMS WERE BROUGHT ACROSS PT AND HELD IN PLACE BY A DRAW SHEET AND TWO SURGICAL CLIPS. THE PT'S LEFT FOOT WAS PLACED IN A LEG HOLDER, AND THEIR RIGHT FOOT WAS HAVING TRACTION APPLIED MANUALLY. A PHYSICIAN WAS IN ATTENDANCE ON THE PT'S RIGHT SIDE, A PELVIC HOLDER WAS IN PLACE BETWEEN PT'S LEGS FOR POSITIONING WHEN THE BOTTOM PIECE OF THE FRACTURE TABLE WAS REMOVED. WITH ELEVATION OF THE BED, THE PT WAS PULLED TO THE RIGHT SIDE, SLID AND SUBSEQUENTLY FELL AGAINST THE PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 5890 FIXED JACKSON TABLE BASE OPERATING ROOM TABLE BWN ORTHOPEDIC SYSTEMS, INC. 5890 *

    Patients

    Seq Age Sex Outcome Treatment
    1 25 YR 5927, RADIOLUCENT IMAGING TABLE (2002 (STOP'D)),| 5855, RADIOLUCENT ORTHOPEDIC TABLE (2002 (STOP'D))