* UNK

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1998-06-19 for * UNK manufactured by Us Army Finer Chrome Products Co. Inc.

Event Text Entries

[120696] On 4/29/1998 at approximately 0845 pt was escorted to castroom in orthopedic clinic for cast check of cast on his left leg. Technician raised back of exam table for pt's comfort and helped him onto table. Technician then proceeded to dr's office to notify him of pt's cast problems. Castroom was still occupied by three other technicians and few pts. Back of exam table evidently collapsed. Pt's middle finger on his left hand got caught in bend of table, he fell backwards against wall and then to floor. Cast technicians rushed to his aid and dr was notified immediately. After administering first aid pt was taken to radiology for x-rays of back, neck and his hand. Xrays revealed no fracture in those areas.
Patient Sequence No: 1, Text Type: D, B5

MAUDE Entry Details

• Report Number: 173332
• MDR Report Key: 173332
• Date Received: 1998-06-19
• Date of Report: 1998-06-15
• Date of Event: 1998-04-29
• Date Facility Aware: 1998-04-29
• Report Date: 1998-06-15
• Date Reported to FDA: 1998-06-17
• Date Added to Maude: 1998-06-23
• Event Key: 0
• Report Source Code: User Facility report
• Manufacturer Link: N
• Number of Patients in Event: 0
• Adverse Event Flag: 3
• Product Problem Flag: 3
• Reprocessed and Reused Flag: 0
• Health Professional: 3
• Initial Report to FDA: 3
• Report to FDA: 3
• Event Location: 3
• Single Use: 0
• Previous Use Code: 0
• Event Type: 3
• Type of Report: 3

Device Details

• Brand Name: *
• Generic Name: PATIENT EXAM TABLE
• Product Code: INW
• Date Received: 1998-06-19
• Model Number: UNK
• Catalog Number: *
• Lot Number: *
• ID Number: *
• Operator: HEALTH PROFESSIONAL
• Device Availability: Y
• Device Age: 15 YR
• Implant Flag: N
• Date Removed: *
• Device Sequence No: 1
• Device Event Key: 168530
• Manufacturer: US ARMY FINER CHROME PRODUCTS CO. INC
• Manufacturer Address: * BRONX NY * US

Patients

Patient Number	Treatment	Outcome	Date
1	0	1. Other	1998-06-19