MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 08 report with the FDA on 2002-06-03 for ERGOSTYLE ERGOSTYLE ELEVATION 8760 manufactured by Chattanooga Group A Division Of Encore Medical L.p..
[231210]
Lifting motor over extended causing the treatment table to fall. No consequences to patient.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1022819-2002-00001 |
| MDR Report Key | 397748 |
| Report Source | 08 |
| Date Received | 2002-06-03 |
| Date of Report | 2002-06-03 |
| Date Mfgr Received | 1999-08-26 |
| Device Manufacturer Date | 1997-10-01 |
| Date Added to Maude | 2002-06-06 |
| 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 | 0 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 0 |
| Manufacturer Contact | MICHAEL TREAS |
| Manufacturer Street | 4717 ADAMS RD |
| Manufacturer City | HIXSON TN 37343 |
| Manufacturer Country | US |
| Manufacturer Postal | 37343 |
| Manufacturer Phone | 4238707218 |
| Manufacturer G1 | * |
| Manufacturer Street | * |
| Manufacturer City | * |
| Manufacturer Country | * |
| Single Use | 3 |
| Remedial Action | OT |
| Previous Use Code | 3 |
| Removal Correction Number | 1180 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | ERGOSTYLE |
| Generic Name | CHIROPRACTIC TREATMENT TABLE |
| Product Code | JFB |
| Date Received | 2002-06-03 |
| Model Number | ERGOSTYLE ELEVATION |
| Catalog Number | 8760 |
| Lot Number | * |
| ID Number | CORRECTIVE ACTION #1180 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | N |
| Implant Flag | N |
| Date Removed | A |
| Device Sequence No | 1 |
| Device Event Key | 386795 |
| Manufacturer | CHATTANOOGA GROUP A DIVISION OF ENCORE MEDICAL L.P. |
| Manufacturer Address | 4717 ADAMS RD. HIXSON TN 37343 US |
| Baseline Brand Name | ERGOSTYLE |
| Baseline Generic Name | CHIROPRACTIC TREATMENT TABLE |
| Baseline Model No | ERGOSTYLE ELEVA |
| Baseline Catalog No | 8760 |
| Baseline ID | CORRECTIVE ACTI |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2002-06-03 |