SUPPORT ARM 177 * 6481720

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2008-05-30 for SUPPORT ARM 177 * 6481720 manufactured by Maquet Critical Care Ab.

Event Text Entries

[924396] It was reported that the support arm was being adjusted while the ventilator was connected to a pt. The support arm broke and hit the pt. The extent of injury is unk.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1225700-2008-00076
MDR Report Key1103603
Date Received2008-05-30
Date of Report2008-05-22
Date of Event2008-05-21
Date Facility Aware2008-05-28
Report Date2008-05-30
Date Added to Maude2008-08-12
Event Key0
Report Source CodeDistributor report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameSUPPORT ARM 177
Generic NameIOY
Product CodeMOD
Date Received2008-05-30
Model Number*
Catalog Number6481720
Lot Number*
ID Number*
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Age*
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key1082877
ManufacturerMAQUET CRITICAL CARE AB
Manufacturer Address* SOLNA * SW


Patients

Patient NumberTreatmentOutcomeDate
10 2008-05-30

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