MAUDE MDR 499485

MDR report key: 499485
Report number: 499485
Event key: 0
Event type: 3
Date of event: 2003-10-15
Date received: 2003-12-03
Adverse event: 3
Product problem: 3
Patients in event: 0
Reporter occupation: 0
Health professional: 3
Initial report to FDA: 3
Event location: 3

Manufacturer Contact#

Report source: U
Manufacturer link flag: N

Devices#

Seq, Brand, Generic table
Seq	Brand	Generic	Manufacturer	Product code	Model	Catalog	Lot	PMA	510(k)	Implant	Evaluated	Availability
1	SKYTRON	OR BED (HYDRAULIC) EE21917	SKYTRON	FWY	21917	*	*			N		Y

Patients#

Sequence, Received, Treatment table
Sequence	Received	Treatment	Outcome
1	2003-12-03	0	1. R

Event Narratives#

D

Patient 1

PATIENT WAS IN OR SUITE FOR COLECTOMY. THE OR TABLE WAS BEING RAISED INTO THE LITHOTOMY POSITION WHEN THE NURSE NOTICED THE ELECTRICAL CORD WAS ON FIRE.

Primary DI, Brand, Company table
Primary DI	Brand	Company	Product code	Published
04057027972793	UFSK-OSYS Treatment table	UFSK-International OSYS GmbH	FWY	2026-03-02
00840763101169	Ulthera System Cart	Ulthera, Inc.	FWY	2024-05-21
B510OT30K0	ADVANCED TABLE, OPERATING-ROOM, NON-ELECTRICAL	ADVANCED INSTRUMENTATIONS, INC.	FWY	2020-05-27

Type, Submission, Product code table
Type	Submission	Product code	Device	Applicant	Decision date
510(k)	K883457	FWY	ASST-3000 SPINAL SURGERY TABLE	Orthopedic Systems, Inc.	1988-08-26
510(k)	K873478	FWY	SKYTRON MODEL 130 SURGICAL TABLE	Skytron, Div. the Kmw Group, Inc.	1987-09-24
510(k)	K833509	FWY	CHEMONUCLEOLYSIS TABLE	Stryker Corp.	1983-11-28
510(k)	K800118	FWY	CHICK SURGICAL TABLE	Warner-Lambert Co.	1980-02-05