BEUDAMED
    FDA Adverse Event Injury Summary report: N

    TABLE

    MDR report key: 8775673 · Received July 10, 2019

    Report

    Report Number
    8775673
    Event Type
    Injury
    Date Received
    July 10, 2019
    Date of Event
    March 26, 2019
    Report Date
    June 13, 2019
    Manufacturer
    MORGAN MEDESIGN, INC.
    Product Code
    FSE
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    AZ
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    THE PATIENT WAS ON ENDO TABLE AND FELL OFF TABLE AND HIT THE FLOOR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    570068 TABLE FSE MORGAN MEDESIGN, INC. FLT-M

    Patients

    Seq Age Sex Outcome Treatment
    1 25550 DA Life Threatening| R