inforMED
InjuryJFB

PHYSICAL THERAPY TABLE

Received Jan 30, 2013 · Event occurred Nov 8, 2012

Report 1022819-2013-00001 · MDR key 2956728

Device

Generic name

Physical Therapy Table

Manufacturer

Djo, Llc

Model number

TRT-200

Product problems

  • Unintended System Motion

Patient

67 YR

  • Fall
  • Fracture, Arm
  • Joint Dislocation

Narrative

Description of Event or Problem

COMPLAINT RECEIVED ALLEGING "OUTPATIENT SAT ON PHYSICAL THERAPY TREATMENT TABLE WHEN IT WAS IN LOW POSITION. AFTER SHE SAT/LAID DOWN THE TABLE BEGAN TO ELEVATE, AND CONTINUED TO RISE. PT FELL OFF THE TABLE, WAS STABILIZED AND SENT TO THE EMERGENCY DEPARTMENT WHERE SHE WAS TREATED FOR A DISLOCATED SHOULDER AND FRACTURED ARM DUE TO THE FALL." INITIAL NOTIFICATION OF COMPLAINT WAS A COPY OF USER FACILITY FORM FDA 3500A REPORT NUMBER (B)(4). NO ADDITIONAL INFORMATION SUPPLIED TO US FOR EVALUATION. PRODUCT NOT RETURNED TO US FOR EVALUATION.