MAUDE Adverse Event Report: FERROUS STAND; IV STAND

Device Problem Electromagnetic Interference (1194)

Patient Problem No Consequences Or Impact To Patient (2199)

Event Date 03/17/2016

Event Type  Other  

Event Description

Ferrous stand was taken into zone 4.Stand was pulled into magnet 1.5 tesla.No injuries reported.Stand was pulled from magnet and test resumed.

• Brand Name: FERROUS STAND
• Type of Device: IV STAND
• MDR Report Key: 5546970
• MDR Text Key: 41944340
• Report Number: MW5061475
• Device Sequence Number: 1
• Product Code: FOX
• Reporter Country Code: US
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Voluntary
• Reporter Occupation: Other Health Care Professional
• Type of Report: Initial
• Report Date: 03/22/2016

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 03/31/2016
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: No
• Device Operator: No Information
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: Yes
• Type of Device Usage: N
• Patient Sequence Number: 1
• Patient Age: 61 YR
• Patient Weight: 75