BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    VERSACARE

    MDR report key: 1171963 · Received September 19, 2008

    Report

    Report Number
    1824206-2008-03495
    Event Type
    Malfunction
    Date Received
    September 19, 2008
    Date of Event
    September 9, 2008
    Report Date
    September 9, 2008
    Manufacturer
    HILL-ROM, RITTER
    Product Code
    FNL
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    THE TSR FOUND THAT THE PRONGS ON THE AC PLUG WERE DISCOLORED BETWEEN THE NEUTRAL AND PHASE. HE REPLACED THE AC PLUG AND THIS RESOLVED THE ARCING.

    Description of Event or Problem · 1

    A HILL-ROM TECHNICAL SERVICE REPRESENTATIVE REPORTED THAT ONE OF THE STAFF PLUGGED THIS BED INTO AN OUTLET AND NOTICED AN ARC. REPORTER SAID, THAT THERE WERE NO REPORTED INJURIES. DUE TO NO INJURY BEING REPORTED, I AM NOT PAGING A FIELD INVESTIGATION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 VERSACARE AC POWERED HOSPITAL BED FNL HILL-ROM, RITTER P3200 NA

    Patients

    Seq Age Sex Outcome Treatment
    1