ORT300 OPERATING ROOM TABLE 114093-000

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-02-19 for ORT300 OPERATING ROOM TABLE 114093-000 manufactured by Imris-deerfield Imaging, Inc..

Event Text Entries

[100558876] The service engineer observed that the hydraulic line of the or table had ruptured. He replaced the ruptured pipe and tested the table to verify proper function.
Patient Sequence No: 1, Text Type: N, H10


[100558877] The customer stated they observed that the ort300 table was leaking hydraulic fluid. There was no patient involvement.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3010326005-2018-00022
MDR Report Key7281109
Date Received2018-02-19
Date of Report2018-07-20
Date of Event2018-02-27
Date Mfgr Received2018-02-27
Device Manufacturer Date2016-02-18
Date Added to Maude2018-02-19
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationBIOMEDICAL ENGINEER
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. TODD SPERLING
Manufacturer Street5101 SHADY OAK ROAD
Manufacturer CityMINNETONKA MN 553434100
Manufacturer CountryUS
Manufacturer Postal553434100
Manufacturer Phone7632036344
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 NameORT300 OPERATING ROOM TABLE
Generic NameOPERATING ROOM TABLE
Product CodeKXJ
Date Received2018-02-19
Model NumberORT300
Catalog Number114093-000
Lot NumberN/A
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerIMRIS-DEERFIELD IMAGING, INC.
Manufacturer Address5101 SHADY OAK ROAD MINNETONKA MN 553434100 US 553434100


Patients

Patient NumberTreatmentOutcomeDate
10 2018-02-19

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