FDA Adverse Event
Malfunction
Summary report: N
KEEPSAFE FALL MONITOR
MDR report key: 1893985
·
Received November 3, 2010
Report
- Report Number
- 2020362-2010-00329
- Event Type
- Malfunction
- Date Received
- November 3, 2010
- Report Date
- September 21, 2010
- Manufacturer
- DONGGUAN POSEY MEDICAL DEVICE LTD.
- Product Code
- KMI
- PMA / PMN Number
- EXEMPT
- Removal / Correction Number
- NA
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- OH, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
(B)(4). RESULTS: EVALUATION OF THE RETURNED PRODUCT FOUND THAT THE ALARM POWERS ON, BUT THERE IS NO ALARM TONE. (B)(4).
Description of Event or Problem · 1
THE CUSTOMER DID NOT SPECIFY THE REASON FOR THE RETURN OF THE PRODUCT. THERE WAS NO PATIENT INCIDENT OR INJURY. MORE INFORMATION RECEIVED ON THE ALARM STATES "NO SOUND". INSPECTION OF THE PRODUCT SHOWS ALARM POWERS ON, BUT THERE IS NO TONE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | KEEPSAFE FALL MONITOR | KMI | DONGGUAN POSEY MEDICAL DEVICE LTD. | 8350 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NI | SQUARE CHAIR SENSOR PAD, MODEL: 8308, LOT NUM: UNK |