BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MIDMARK

    MDR report key: 4990313 · Received August 1, 2015

    Report

    Report Number
    1523530-2015-00005
    Event Type
    Malfunction
    Date Received
    August 1, 2015
    Date of Event
    July 8, 2015
    Report Date
    July 31, 2015
    Manufacturer
    MIDMARK CORP.
    Product Code
    LGX
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    MIDMARK RECEIVED THE UNIT AND CONTINUES INVESTIGATION. NO ROOT CAUSE HAS YET BEEN DETERMINED. MIDMARK WILL PROVIDE FURTHER UPDATE UPON CONCLUSION OF INVESTIGATION OR VERIFICATION OF ROOT CAUSE.

    Description of Event or Problem · 1

    PATIENT WAS IN THE SEATED POSITION. THE MEDICAL ASSISTANT LOWERED THE BACK AND HEARD A NOISE. THE TOP END OF THE TABLE DROPPED TOWARD THE FLOOR. NO INJURIES REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    502945 MIDMARK PROCEDURE TABLE LGX MIDMARK CORP. 630-020

    Patients

    Seq Age Sex Outcome Treatment
    1