BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    VEST MODEL 104

    MDR report key: 1051184 · Received May 22, 2008

    Report

    Report Number
    1045510-2008-00004
    Event Type
    Malfunction
    Date Received
    May 22, 2008
    Date of Event
    April 23, 2008
    Report Date
    May 22, 2008
    Manufacturer
    HILL-ROM CHARLESTON
    Product Code
    BYI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MN, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    A POOR ELECTRICAL CONNECTION AT OR WITHIN THE POWER INLET FILTER WAS THE CAUSE OF THE OVERHEATING ISSUE.

    Description of Event or Problem · 1

    IT WAS REPORTED TO HILL-ROM THAT THE DEVICE CAUGHT FIRE AND REPORTEDLY THE CARPET WAS BURNED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 VEST MODEL 104 POWERED PERCUSSOR BYI HILL-ROM CHARLESTON 104

    Patients

    Seq Age Sex Outcome Treatment
    1 86 YR