MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1999-12-29 for WILLIAMS MANUFACTURING 800800C NA manufactured by Williams Healthcare Systems.
[21717270]
Roller bed malfunctioned, possibly came off track. When turned on, pop in machine was heard and then turned off.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | MW1017864 |
| MDR Report Key | 257740 |
| Date Received | 1999-12-29 |
| Date of Report | 1999-12-20 |
| Date of Event | 1999-12-16 |
| Date Added to Maude | 2000-01-11 |
| Event Key | 0 |
| Report Source Code | Voluntary 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 | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 0 |
| Report to FDA | 0 |
| Event Location | 3 |
| Single Use | 0 |
| Previous Use Code | 0 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | WILLIAMS MANUFACTURING |
| Generic Name | COMBI IV TRACTION |
| Product Code | JFB |
| Date Received | 1999-12-29 |
| Model Number | 800800C |
| Catalog Number | NA |
| Lot Number | NA |
| ID Number | * |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Implant Flag | N |
| Date Removed | A |
| Device Sequence No | 1 |
| Device Event Key | 249595 |
| Manufacturer | WILLIAMS HEALTHCARE SYSTEMS |
| Manufacturer Address | 158 N. EDISON AVE. ELGIN IL 60123 US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 1999-12-29 |