BEUDAMED
    FDA Adverse Event Other Summary report: N

    5890, FIXED JACKSON TABLE BASE

    MDR report key: 476053 · Received July 29, 2003

    Report

    Report Number
    2921578-2003-00003
    Event Type
    Other
    Date Received
    July 29, 2003
    Report Date
    March 17, 2003
    Manufacturer
    ORTHOPEDIC SYSTEMS, INC.
    Product Code
    BWN
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MO, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PT WAS TAKEN TO SURGERY, PLACED IN SUPINE POSITION ON THE FRACTURE TABLE. AT THE END OF THE CASE AFTER FOOT BOARD HAD BEEN REPLACED, THE PT WAS MOVING ON THE FRACTURE TABLE. STAFF MEMBERS WERE POSITIONED ON BOTH SIDES OF THE PT. SAFETY STRAP WAS IN PLACE OVER CHEST. AS CENTER POST WAS REMOVED, AND STAFF MEMBER TURNED TO PUT IT DOWN, THE PT ATTEMPTED TO ROLL CAUSING THEIR LEGS TO FALL OFF THE TABLE. THE SAFETY STRAP CAUGHT THE PT'S UPPER BODY AS THE STRAP WAS RELEASED BY THE OTHER STAFF MEMBER AND THE PT WAS LOWERED GENTLY TO FLOOR. THE PHYSICIAN WAS NOTIFIED AND EXAMINED THE PT. THE PT WAS LIFTED INTO A HOSPITAL BED AND X-RAYS WERE TAKEN. EXAM AND X-RAYS WERE NEGATIVE.

    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 88 YR Required Intervention 5927 RADIOLUCENT IMAGING TABLE (2003) (STOP'D)).| 5855 RADIOLUCENT ORTHOPEDIC TABLE (2003) (STOP'D))