MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 06 report with the FDA on 2011-06-22 for MIDMARK 623-007 manufactured by Midmark Corp..
[2126790]
Table reportedly dropped while a pt was sitting on it.
Patient Sequence No: 1, Text Type: D, B5
[9204641]
The device was tested and no defect was found. The table operated according to its specifications.
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 1523530-2011-00019 |
| MDR Report Key | 2170745 |
| Report Source | 06 |
| Date Received | 2011-06-22 |
| Date of Report | 2011-06-22 |
| Date of Event | 2011-05-25 |
| Date Mfgr Received | 2011-05-25 |
| Device Manufacturer Date | 2010-03-01 |
| Date Added to Maude | 2011-08-31 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | BIOMEDICAL ENGINEER |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 0 |
| Event Location | 0 |
| Manufacturer Contact | DONALD CARR |
| Manufacturer Street | 60 VISTA DR. |
| Manufacturer City | VERSAILLES OH 45380 |
| Manufacturer Country | US |
| Manufacturer Postal | 45380 |
| Manufacturer Phone | 9375263662 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | MIDMARK |
| Generic Name | CHAIR, SURGICAL, AC-POWERED |
| Product Code | GBB |
| Date Received | 2011-06-22 |
| Returned To Mfg | 2011-06-13 |
| Model Number | 623-007 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Age | DA |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MIDMARK CORP. |
| Manufacturer Address | VERSAILLES OH US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2011-06-22 |