MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2010-11-22 for * 5120 manufactured by United Metal Fabricators, Inc.
[1675638]
Patient stepped with both feet on the step at the foot of the exam table and the table upended causing the patient to loose his balance. In an effort to avoid falling the patient twisted his knee. ======================health professional's impression======================uneven distribution of weight
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1920006 |
| MDR Report Key | 1920006 |
| Date Received | 2010-11-22 |
| Date of Report | 2010-11-22 |
| Date of Event | 2010-11-05 |
| Report Date | 2010-11-22 |
| Date Reported to FDA | 2010-11-22 |
| Date Added to Maude | 2010-12-10 |
| 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 |
| Reporter Occupation | RISK MANAGER |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 0 |
| Single Use | 0 |
| Previous Use Code | 0 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | * |
| Generic Name | EXAM TABLE |
| Product Code | LGX |
| Date Received | 2010-11-22 |
| Model Number | 5120 |
| Catalog Number | * |
| Lot Number | * |
| ID Number | * |
| Device Availability | Y |
| Device Age | 15 YRS |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | UNITED METAL FABRICATORS, INC |
| Manufacturer Address | 1316 EISENHOWER BOULEVARD JOHNSTOWN PA 15904 US 15904 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention; 2. Deathisabilit | 2010-11-22 |