BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HILL ROM

    MDR report key: 2013482 · Received March 7, 2011

    Report

    Report Number
    MW5019696
    Event Type
    Injury
    Date Received
    March 7, 2011
    Date of Event
    January 25, 2011
    Report Date
    March 7, 2011
    Manufacturer
    HILL ROM
    Product Code
    FNL
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    ND, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT'S MOTHER SAW SPARKS COMING FROM BED. NURSING STAFF RESPONDED. PT WAS IN GRANDFATHER'S LAP IN CHAIR. NO FIRE WAS SEEN, BUT ROOM SMELLED "HOT." STAFF ASKED GRANDFATHER TO PICK PT UP AND CARRY OUT OF ROOM. PT ROOM DOOR WAS SHUT. FIRE ALARM PULLED AND CODE RED CALLED TO SWITCHBOARD. FACILITIES MANAGEMENT STAFF ARRIVED. ROOM DOOR OPENED AND SMOKE NOTED. UNPLUGGED THE BED. BED INSPECTED. FLAMES NOTED, SO FIRE EXTINGUISHER USED TO PUT OUT FLAMES. SAFETY OFFICER AND FIRE DEPARTMENT ARRIVED. RECEIVED UPDATE. OTHER PTS ALLOWED TO REMAIN IN ROOMS. FIREMEN REMOVED BED FROM ROOM AND AREA. PER BED EXAM, FIRE ORIGINATED NEAR ACTUATOR MOTOR CAPACITATOR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HILL ROM PATIENT BED FNL HILL ROM 850 CENTRA

    Patients

    Seq Age Sex Outcome Treatment
    1 3 YR Disability