BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MATTRESS

    MDR report key: 17533215 · Received August 12, 2023

    Report

    Report Number
    MW5140119
    Event Type
    Injury
    Date Received
    August 12, 2023
    Date of Event
    May 17, 2021
    Report Date
    June 25, 2021
    Manufacturer
    MOXI
    Product Code
    FNM
    Report Source
    Voluntary report
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 0

    ON (B)(6) AND (B)(6) SLID FROM MATTRESS DUE TO AIR MOVING. (B)(6) HE HAS FALLEN TWICE. SERVICE ORDER WAS DONE BY (B)(6) ON (B)(6) 2021. I ASKED HER ABOUT THIS ISSUE AND SHE REPLIED HELLO, I CHECKED THE PR REQUEST. (B)(6) HAD ASSISTED (B)(4) REGARDING THIS ORDER. I DO NOT SEE THAT THERE WAS A REPORT CREATED." SO I DID THE QVR (B)(4) SERVICE NO COVID-19. (B)(6) FOAM MATTRESS - PLEASE BRING TO SWITCH OUT THE AIR MATTRESS. PER (B)(6) (B)(6) 2021 2:57 PM): IF THEY ARE LOOKING TO RETURN THE LAL AND SWITCH TO FOAM. PLEASE CREATE A SERVICE TO HAVE IT SWITCHED OUT. THE BED THEY ORDERED INCLUDES A FOAM MATT IN THE RENTAL RATE, SO NOTHING TO ADD. ACTION REQUIRED: THE MANUFACTURER WAS NOTIFIED JUNE 25, 2021. (B)(4) SERVICE (B)(4). THIS REPORT REFLECTS INFORMATION RECEIVED BY FDA IN THE FORM OF A NOTIFICATION PER 803.22 (B)(2).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    784858 MATTRESS MATTRESS, AIR FLOTATION, ALTERNATING PRESSURE FNM MOXI 1-2. ST AT 5000CB - SA48MA TT

    Patients

    Seq Age Sex Outcome Treatment
    1 71 YR Unknown