IMRIS T2X OR TABLE V2 (ORT100) 110470-000

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-11-13 for IMRIS T2X OR TABLE V2 (ORT100) 110470-000 manufactured by Imris - Deerfield Imaging, Inc..

Event Text Entries

[93077740] The field service engineer replaced the roll hydraulic cylinder on the table. The hydraulic system was flushed and bled of air. The table was functionally tested after the repair to verify proper function.
Patient Sequence No: 1, Text Type: N, H10


[93077741] The ort100 table drifted during a procedure. Once the drift was noticed, the table was moved back into proper position and the case proceeded successfully. There was no patient injury reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3010326005-2017-00010
MDR Report Key7026583
Date Received2017-11-13
Date of Report2017-11-13
Date of Event2017-10-24
Date Mfgr Received2017-10-24
Device Manufacturer Date2010-11-17
Date Added to Maude2017-11-13
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. SANJAY SHAH
Manufacturer Street5101 SHADY OAK ROAD
Manufacturer CityMINNETONKA MN 553434100
Manufacturer CountryUS
Manufacturer Postal553434100
Manufacturer Phone7632036380
Manufacturer G1IMRIS - DEERFIELD IMAGING, INC.
Manufacturer Street5101 SHADY OAK ROAD
Manufacturer CityMINNETONKA MN 553434100
Manufacturer CountryUS
Manufacturer Postal Code553434100
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameIMRIS T2X OR TABLE V2 (ORT100)
Generic NameOPERATING ROOM TABLE
Product CodeKXJ
Date Received2017-11-13
Model NumberORT100
Catalog Number110470-000
OperatorNURSE
Device AvailabilityY
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerIMRIS - DEERFIELD IMAGING, INC.
Manufacturer Address5101 SHADY OAK ROAD MINNETONKA MN 553434100 US 553434100


Patients

Patient NumberTreatmentOutcomeDate
10 2017-11-13

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