BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ADVANTAGE SERIES 26

    MDR report key: 1940382 · Received December 9, 2010

    Report

    Report Number
    1831750-2010-04686
    Event Type
    Malfunction
    Date Received
    December 9, 2010
    Date of Event
    November 12, 2010
    Report Date
    November 12, 2010
    Manufacturer
    STRYKER CORP., MEDICAL DIV.
    Product Code
    FPO
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Additional Manufacturer Narrative · 1

    IV POLE ASSEMBLY.

    Description of Event or Problem · 1

    IT WAS REPORTED BY SERVICE REPORT THAT THE IV POLE SNAPPED OFF AT THE TOP THREADED PORTION OF THE MIDDLE STAGE. NO PT INVOLVEMENT OR ADVERSE CONSEQUENCES ARE REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ADVANTAGE SERIES 26 HOSPITAL WHEELED STRETCHER FPO STRYKER CORP., MEDICAL DIV. 1001 NA

    Patients

    Seq Age Sex Outcome Treatment
    1