CARROM SERIES 7593-603

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1992-07-07 for CARROM SERIES 7593-603 manufactured by Affiliated Hospital Product, Inc..

Event Text Entries

[16263293] Client was admitted the afternoon of january 16th. He was aware of admission and answered questions appropriately during the day. In the evening and during the night of january 17th, client was somewhat confused, (even by his how statement). During the early morning hours of jan. 17th client scooted down to the foot end of the bed, somehow he got his legs caught in the side rails. The siderail fell on his right leg and he sustained a long (27-29 cm) excoriation of the shin. This was cleansed and dressed with tegaderm. The dressing is changed daily. In the morning, i was told the siderail did not stay up during the night shift. When the side rail was checked by maintenance, they found the knob turned sideways, straightenefd it and the side rails works well and hold fastdevice labeled for single use. Patient medical status prior to event: fair condition. There was not multiple patient involvement. Invalid data - on device service/maintenance. No data - regarding date last serviced. Service provided by: invalid data. Invalid data - service records availability. No imminent hazard to public health claimed. Device used as labeled/intended. Device was evaluated after the event. Method of evaluation: actual device involved in incident was evaluated, performance tests performed, visual examination. Results of evaluation: design - human factors, mechanical problem, patient's condition - predisposed event. Conclusion: device failure occurred and was related to event, device failure related to patient condition, device evaluated and alleged failure could not be duplicated, user error contributed to event. Certainty of device as cause of or contributor to event: maybe. Corrective actions: device repaired and put back in service, device temporarily removed from service, user education provided. Invalid data - on device destroyed/disposed of status.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3639
MDR Report Key3639
Date Received1992-07-07
Date of Report1992-01-21
Date of Event1992-01-17
Date Facility Aware1992-01-17
Report Date1992-01-21
Date Reported to FDA1992-01-21
Date Reported to Mfgr1992-01-21
Date Added to Maude1993-04-28
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Health Professional0
Initial Report to FDA0
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameCARROM SERIES
Generic NameSIDE RAILS
Product CodeFNK
Date Received1992-07-07
Model Number7593-603
Lot NumberUNKNOWN
ID Number603-E
OperatorOTHER HEALTH CARE PROFESSIONAL
Device AvailabilityY
Implant FlagN
Device Sequence No1
Device Event Key3385
ManufacturerAFFILIATED HOSPITAL PRODUCT, INC.


Patients

Patient NumberTreatmentOutcomeDate
101. Other 1992-07-07

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