BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SM104 MSERIES W5TH WHL

    MDR report key: 1958402 · Received December 15, 2010

    Report

    Report Number
    1831750-2010-04887
    Event Type
    Malfunction
    Date Received
    December 15, 2010
    Date of Event
    November 5, 2010
    Report Date
    November 5, 2010
    Manufacturer
    STRYKER CORP, MED DIV
    Product Code
    FPO
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NV, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Additional Manufacturer Narrative · 1

    RESULTS: IV POLE.

    Description of Event or Problem · 1

    IT WAS REPORTED IN A SERVICE REPORT THERE WERE BAD HYDRAULICS AND A BROKEN IV POLE. NO PT INVOLVEMENT OR ADVERSE CONSEQUENCES ARE REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SM104 MSERIES W5TH WHL HOSPITAL WHEELED STRETCHER FPO STRYKER CORP, MED DIV 1005 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 NA