BEUDAMED
    FDA Adverse Event Injury Summary report: N

    INX FOR INLINE WITH DWL

    MDR report key: 11992866 · Received June 14, 2021

    Report

    Report Number
    1523574-2021-00006
    Event Type
    Injury
    Date Received
    June 14, 2021
    Date of Event
    May 25, 2021
    Report Date
    June 28, 2021
    Manufacturer
    FERNO-WASHINGTON, INC.
    Product Code
    FPO
    UDI-DI
    00190790001339
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 0

    THE STRETCHER WAS RETURNED TO FERNO AND A VISUAL AND FUNCTION TEST WAS PERFORMED. THE SAFETY BAIL WAS FOUND TO BE DAMAGED NOT ALLOWING THE BAIL TO CORRECTLY ENGAGE THE SAFETY HOOK. THE TECHNICIAN ALSO FOUND THE SAFETY BAIL RELEASE STOPS WERE GOUGED INDICATING THE SAFETY BAIL IS HITTING THE STOPS WITH FORCE. THE COT WAS REPAIRED AND APPROVED TO RETURN TO SERVICE. NO ADDITIONAL DETAILS WERE PROVIDED REGARDING THE ALLEGED INJURY (HEADACHE).

    Description of Event or Problem · 0

    IT WAS REPORTED WHILE UNLOADING THE STRETCHER FROM THE AMBULANCE, IT ALLEGEDLY DID NOT ENGAGE WITH THE SAFETY HOOK AND CONTINUED TO ROLL OUT OF THE AMBULANCE STRIKING THE BUMPER. THE PATIENT ALLEGED A HEADACHE AS A RESULT.

    Description of Event or Problem · 1

    IT WAS REPORTED WHILE UNLOADING THE STRETCHER FROM THE AMBULANCE, IT ALLEGEDLY DID NOT ENGAGE WITH THE SAFETY HOOK AND CONTINUED TO ROLL OUT OF THE AMBULANCE STRIKING THE BUMPER. THE PATIENT ALLEGED A HEADACHE AS A RESULT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    892739 INX FOR INLINE WITH DWL INX FOR INLINE WITH DWL FPO FERNO-WASHINGTON, INC. 0015811 00190790001339

    Patients

    Seq Age Sex Outcome Treatment
    1 Other