MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-11-18 for MIDMARK 630 manufactured by Midmark.
[60689329]
The doctor at (b)(6) reported the 630 midmark universal procedure table moved with patient on the table during a procedure. No injury was reported.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1523530-2016-00003 |
| MDR Report Key | 6114224 |
| Date Received | 2016-11-18 |
| Date of Report | 2016-11-18 |
| Date of Event | 2016-09-27 |
| Date Mfgr Received | 2016-09-27 |
| Device Manufacturer Date | 2014-08-08 |
| Date Added to Maude | 2016-11-18 |
| 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 | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | JANE CARROLL |
| Manufacturer Street | 60 VISTA DR. |
| Manufacturer City | VERSAILLES OH 45380 |
| Manufacturer Country | US |
| Manufacturer Postal | 45380 |
| Manufacturer G1 | MIDMARK |
| Manufacturer Street | 60 VISTA DR. |
| Manufacturer City | VERSAILLES OH 45380 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 45380 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 0 |
| Brand Name | MIDMARK |
| Generic Name | 630 UNIVERSAL PROCEDURE TABLE |
| Product Code | INQ |
| Date Received | 2016-11-18 |
| Model Number | 630 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | * |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MIDMARK |
| Manufacturer Address | 60 VOSTA DR VERSAILLES OH 45380 US 45380 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2016-11-18 |