BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LASERSCOPE SURGICAL EQUIP. MANAGER

    MDR report key: 87226 · Received April 24, 1997

    Report

    Report Number
    2937094-1997-00009
    Event Type
    Injury
    Date Received
    April 24, 1997
    Date of Event
    March 27, 1997
    Report Date
    April 22, 1997
    Manufacturer
    LASERSCOPE
    Product Code
    LDQ
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NJ, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    ON 3/27/97, A SURGICAL AID WAS SETTING UP OR #5: THE AIR BRAKE WAS RELEASED AND THE LASERSCOPE MODEL 910 CEILING COLUMN WITH SURGICAL EQUIPMENT MANAGER JERKED CAUSING A PVM 2030 SONY MONITOR (WHICH WAS UNSECURED ON THE SHELF) TO FALL, STRIKING AN EMPLOYEES'S SHOULDER, NECK AND ARM. THE EMPLOYEE WENT TO THE EMERGENCY ROOM FOR EVALUATION AND WAS OFF WORK FROM 3/27/97 - 4/1/97. DETAILED EXTENT OF INJURIES ARE UNKNOWN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LASERSCOPE SURGICAL EQUIP. MANAGER SHELF BOX LDQ LASERSCOPE * *

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Other