BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ULTRA CART

    MDR report key: 1940095 · Received December 22, 2010

    Report

    Report Number
    MW5018694
    Event Type
    Malfunction
    Date Received
    December 22, 2010
    Date of Event
    December 14, 2010
    Report Date
    December 22, 2010
    Manufacturer
    JACO
    Product Code
    LNX
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MD, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    INVERTER BOARD USED IN JACO BATTERY PACK ON COMPUTER CART (WORKSTATION ON WHEELS) LOCATED IN THE BURN INTENSIVE CARE UNIT, CAUGHT FIRE NECESSITATING SUPPRESSION, FIRE DEPARTMENT RESPONSE, AND EVACUATION/RELOCATION OF PTS, VISITORS AND STAFF. NO INJURIES WERE SUSTAINED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ULTRA CART COMPUTER CART WITH BATTERY PACK LNX JACO

    Patients

    Seq Age Sex Outcome Treatment
    1 Other