FDA Adverse Event Other Summary report: N

CUSTOM COMFORT INC.

MDR report key: 918953 · Received September 24, 2007

Report

Report Number
MW5003898
Event Type
Other
Date Received
September 24, 2007
Manufacturer
CUSTOM COMFORT
Product Code
INN
Report Source
Voluntary report
Reporter Location
CT, US
Reporter Occupation
RISK MANAGER

Narratives

Description of Event or Problem · 1

DURING PHLEBOTOMY, PATIENT BECAME UNCONSCIOUS AND SLID BACK INTO CHAIR. PATIENT NECK SLIPPED BETWEEN SIDE ARM AND BACK OF CHAIR. DIFFICULTY REMOVING HEAD FROM THIS LOCATION, BUT EVENTUALLY ABLE TO .

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CUSTOM COMFORT INC. BLOOD DRAW CHAIR INN CUSTOM COMFORT

Patients

Seq Age Sex Outcome Treatment
1 YR Other