BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    INX FOR INLINE WITH DWL

    MDR report key: 16613211 · Received March 24, 2023

    Report

    Report Number
    1523574-2023-00006
    Event Type
    Malfunction
    Date Received
    March 24, 2023
    Date of Event
    March 19, 2023
    Report Date
    July 30, 2023
    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
    Health Professional
    Yes

    Narratives

    Additional Manufacturer Narrative · 0

    THE CUSTOMER CONTACTED THEIR SERVICE PROVIDER TO CONDUCT A PM EVALUATION ON THE STRETCHER. DAMAGE AS A RESULT OF THE REPORTED INCIDENT WAS OBSERVED. THE REPORTED OBSTRUCTION OVER THE SAFETY HOOK IS ATTRIBUTED AS THE CONTRIBUTING FACTOR TO THE INCIDENT.

    Description of Event or Problem · 0

    IT WAS REPORTED WHILE UNLOADING A PATIENT FROM THE AMBULANCE THE SAFETY BAIL DID NOT ENGAGE WITH THE HOOK AND THE STRETCHER LOWERED TO THE BUMPER AND THEN TIPPED TO THE GROUND. IT WAS DISCOVERED AN OBSTRUCTION WAS COVERING THE SAFETY HOOK WHICH CAUSED THE SAFETY BAIL TO NOT ENGAGE WITH THE HOOK. IT WAS REPORTED THE PATIENT SUSTAINED INJURY TO THE HEAD AND RIGHT SHOULDER AS A RESULT OF CONTACTING THE GROUND. THE NATURE OF INJURIES WAS DESCRIBED AS LACERATION AND SOFT TISSUE INJURY.

    Description of Event or Problem · 0

    IT WAS REPORTED WHILE UNLOADING A PATIENT FROM THE AMBULANCE THE SAFETY BAIL DID NOT ENGAGE WITH THE HOOK AND THE STRETCHER LOWERED TO THE BUMPER AND THEN TIPPED TO THE GROUND. IT WAS DISCOVERED AN OBSTRUCTION WAS COVERING THE SAFETY HOOK WHICH CAUSED THE SAFETY BAIL TO NOT ENGAGE WITH THE HOOK. IT WAS REPORTED THE PATIENT SUSTAINED INJURY TO THE HEAD AND RIGHT SHOULDER AS A RESULT OF CONTACTING THE GROUND. THE NATURE OF INJURIES WAS DESCRIBED AS LACERATION AND SOFT TISSUE INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    373087 INX FOR INLINE WITH DWL INX FOR INLINE WITH DWL FPO FERNO-WASHINGTON, INC. 0015811 00190790001339

    Patients

    Seq Age Sex Outcome Treatment
    1 51 YR Male Other