inforMED
MalfunctionGBB

SHOULDER POSITIONING SYSTEM TABLE

Received Feb 3, 2022 · Event occurred Jan 28, 2022

Report MW5107201 · MDR key 13453864

Device

Generic name

Chair, Surgical, Ac-powered

Model number

800-0004

Catalog number

800-0004

Product problems

  • Device Fell

Patient

43 YR · Male

  • Fall
  • Fall

Narrative

Description of Event or Problem

WHILE PT WAS MOVING OVER TO OPERATING ROOM BED (SCHUREMED) THE UPPER HALF OF THE OPERATING ROOM BED FELL BACK AND PT SLID BACKWARDS AND HAD AN ASSISTED FALL. THE UPPER HALF OF BED SHEARED OFF, NOT AT A CONNECTION POINT. FDA SAFETY REPORT ID# (B)(4).