INFO REQUESTED FROM HOSP X-RAY MACHINE FLAT BED (OLDER MODEL)

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2011-11-15 for INFO REQUESTED FROM HOSP X-RAY MACHINE FLAT BED (OLDER MODEL) manufactured by Unk.

Event Text Entries

[2353511] Exam: dx4-0446 hip left 2+ views (b)(6). (b)(6), x-ray tech/examiner and x-ray tech/ trainee, rm #rad-ah. Technique: ap pelvis & frog leg view left hip. No acute fracture dislocation. Injury/symptoms resulting from hip x-rays: skin remains tender to the touch. Sensation of internal tearing of skin. Sharp shooting pains (nerves run directly through x-rayed areas. Touching of skin results in sharp shooting pains in both (touched skin areas and untouched skin areas, resulting from the x-rays). (b)(6) hosp refused to examine me or to provide any assistance in this matter. Something went wrong during this x-ray procedure either with the x-ray tech or the person he was training and or the x-ray machine. I have requested info regarding x-ray machine from vhd to no avail. However they did inform me that the x-ray machine had been serviced.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5023123
MDR Report Key2341877
Date Received2011-11-15
Date of Report2011-11-07
Date of Event2011-10-27
Date Added to Maude2011-11-21
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationPATIENT
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameINFO REQUESTED FROM HOSP
Generic NameX-RAY MACHINE FLAT BED (OLDER MODEL)
Product CodeIZO
Date Received2011-11-15
Model NumberX-RAY MACHINE FLAT BED (OLDER MODEL)
OperatorOTHER
Device Sequence No1
Device Event Key0
ManufacturerUNK
Manufacturer AddressUNK UNK


Patients

Patient NumberTreatmentOutcomeDate
101. Other; 2. Deathisabilit 2011-11-15

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