FDA Adverse Event Other Summary report: N

INNOVA 4100 OMEGA V

MDR report key: 838421 · Received February 20, 2007

Report

Report Number
9611343-2007-00008
Event Type
Other
Date Received
February 20, 2007
Date of Event
January 25, 2007
Report Date
February 20, 2007
Manufacturer
GE MEDICAL SYSTEMS SCS
Product Code
IZI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE INVESTIGATION INTO ROOT CAUSE IS ONGOING.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PATIENT NEARLY FELL WHILE BEING TRANSFERRED FROM A GURNEY TO THE TABLE. THE PATIENT LANDED FEEL FIRST, CATCHING HIMSELF AND PREVENTING THE FALL. AN INJURY WAS NOT REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INNOVA 4100 OMEGA V VASCULAR IZI GE MEDICAL SYSTEMS SCS 2320045-2 NA

Patients

Seq Age Sex Outcome Treatment
1 78 YR