FDA Adverse Event Death Summary report: N

POSEY BED ALL-IN-ONE SYSTEM

MDR report key: 1899966 · Received November 10, 2010

Report

Report Number
2020362-2010-00351
Event Type
Death
Date Received
November 10, 2010
Date of Event
October 21, 2010
Report Date
October 21, 2010
Manufacturer
POSEY, S. DE R. L. DE C. V.
Product Code
FNL
PMA / PMN Number
EXEMPT
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). PRODUCT WAS REQUESTED TO BE RETURNED FOR EVAL AND HAS NOT BEEN REC'D. THERE WAS NO PRODUCT PROBLEM RELATED TO THE PT EVENT REPORTED. MFR REFERENCES FILE (B)(4).

Description of Event or Problem · 1

CUSTOMER REPORTED THAT A CODE BLUE OCCURRED WHILE A PT WAS IN THE PRODUCT BED MODEL 8070. THE NURSING STAFF ATTEMPTED TO REACH THE PT IN ORDER TO ADMINISTER CPR, BUT THE PT PASSED AWAY. THERE WAS NO PRODUCT BED DAMAGE RELATED TO THIS EVENT REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 POSEY BED ALL-IN-ONE SYSTEM FNL POSEY, S. DE R. L. DE C. V. 8070 NA

Patients

Seq Age Sex Outcome Treatment
1 90 YR Death