BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    *

    MDR report key: 48022 · Received November 4, 1996

    Report

    Report Number
    1418954-1996-00001
    Event Type
    Malfunction
    Date Received
    November 4, 1996
    Manufacturer
    CONTINENTAL X RAY CORP.
    Product Code
    KXJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    WHILE RADIOLOGIST WAS TILTING TABLE, NEAR 45 DEGREES MAIN DRIVE CHAIN FROM GEAR REDUCER SNAPPED AND TABLE FELL GOING PAST HORIZONTAL THEN RETURNING TO REST AT HORIZONTAL. PT ON TABLE FELL OFF. NO APPARENT INJURY BUT SENT TO HOSP FOR CONFIRMATION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * R/F TABLE KXJ CONTINENTAL X RAY CORP. 6806.101 *

    Patients

    Seq Age Sex Outcome Treatment
    1 57 YR