OtherILC
SERCO
Received Oct 31, 1998 · Event occurred Oct 27, 1998
Report 196079 · MDR key 196079
Device
Generic name
Table Ware (fork)
Manufacturer
U:s:food ServiceModel number
41963Catalog number
MADE IN JAPAN
Lot number
*
Product problems
- Foreign material
Patient
10 YR
- Unknown (for use when the patient's condition is not known)
Narrative
Description of Event or Problem
ON 10/27/98, THE PATIENT'S MOTHER PICKED UP A FORK FROM THE PATIENT'S LUNCH TRAY TO FEED THE PATIENT. SUDDENLY, SHE SAW 2 ROUNDED METAL 1.5 MM OBJECTS ON THE PLATE. FURTHER INSPECTION BY THE DIR. OF DIETARY DEPT. SHOWED MORE ROUNDED OBJECTS STUCK BETWEEN THE STICKS OF SEVERAL FORKS.