MIDMARK 625-001

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 00,06 report with the FDA on 2011-06-27 for MIDMARK 625-001 manufactured by Midmark Corp..

Event Text Entries

[20956572] The customer stated the table lowered 2 inches with a pt on the table.
Patient Sequence No: 1, Text Type: D, B5


[21223289] An independent service company inspected the table. They could find no problems that would have caused the table to suddenly lower the 2 inches reported by the operator.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1523530-2011-00020
MDR Report Key2187417
Report Source00,06
Date Received2011-06-27
Date of Report2011-06-23
Date of Event2011-06-01
Date Mfgr Received2011-06-01
Device Manufacturer Date2010-10-01
Date Added to Maude2012-05-10
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactDONALD CARR
Manufacturer Street60 VISTA DR.
Manufacturer CityVERSAILLES OH 45380
Manufacturer CountryUS
Manufacturer Postal45380
Manufacturer Phone9375263662
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameMIDMARK
Generic NameCHAIR, SURGICAL, AC-POWERED
Product CodeGBB
Date Received2011-06-27
Model Number625-001
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerMIDMARK CORP.
Manufacturer AddressVERSAILLES OH US


Patients

Patient NumberTreatmentOutcomeDate
10 2011-06-27

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