BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SM104 MSERIES W5TH WHL

    MDR report key: 1972321 · Received December 30, 2010

    Report

    Report Number
    1831750-2010-05420
    Event Type
    Malfunction
    Date Received
    December 30, 2010
    Date of Event
    December 3, 2010
    Report Date
    December 3, 2010
    Manufacturer
    STRYKER CORP., MEDICAL DIV.
    Product Code
    FPO
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED BY SERVICE REPORT THAT THE HEADEND JACK WAS DRIFTING DOWN. IT IS UNK IF THERE WAS PT INVOLVEMENT OR IF THERE ARE ADVERSE CONSEQUENCES TO REPORT.

    Devices

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

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK