BEUDAMED
    FDA Adverse Event Other Summary report: N

    MAQUET

    MDR report key: 963570 · Received December 7, 2004

    Report

    Report Number
    8010652-2004-00002
    Event Type
    Other
    Date Received
    December 7, 2004
    Report Date
    November 8, 2004
    Manufacturer
    MAQUET GMBH
    Product Code
    FQO
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    USER FACILITY ACKNOWLEDGES THAT THIS WAS NOT CAUSED BY EQUIPMENT FAILURE. HEADREST WAS NOT PROPERLY LOCKED INTO PLACE.

    Description of Event or Problem · 1

    AS OR STAFF WAS MOVING THE TABLE A MEDICAL STUDENT TAPPED THE HEAD OF THE OR TABLE WITH THEIR HIP AND THE HEADREST FELL OFF; THE PTS NECK HYPEREXTENDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MAQUET SURGICAL TABLE FQO MAQUET GMBH 1130.67FO *

    Patients

    Seq Age Sex Outcome Treatment
    1 *