BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ADVANCE 1000

    MDR report key: 1850191 · Received September 22, 2010

    Report

    Report Number
    1824206-2010-10076
    Event Type
    Malfunction
    Date Received
    September 22, 2010
    Date of Event
    August 27, 2010
    Report Date
    August 27, 2010
    Manufacturer
    HILL-ROM, INC.
    Product Code
    FNL
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AZ, US
    Reporter Occupation
    BIOMEDICAL ENGINEER

    Narratives

    Additional Manufacturer Narrative · 1

    A NEW CASTER BASE WAS SHIPPED TO THE ACCOUNT FOR RESOLUTION. NO FURTHER INFO IS AVAILABLE AT THIS TIME.

    Description of Event or Problem · 1

    ACCOUNT ALLEGED THAT THE LEFT FOOT CASTER TUBE PULLED AWAY FROM THE FRAME AND CAUSED THE BED TO DROP. A PT WAS IN BED, NO INJURIES HAVE BEEN ALLEGED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ADVANCE 1000 AC POWERED ADJUSTABLE HOSPITAL BED FNL HILL-ROM, INC. P1105

    Patients

    Seq Age Sex Outcome Treatment
    1