BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    XPRT MATTRESS W/O PENDANT

    MDR report key: 2031688 · Received February 24, 2011

    Report

    Report Number
    1313850-2011-00017
    Event Type
    Malfunction
    Date Received
    February 24, 2011
    Date of Event
    January 27, 2011
    Report Date
    January 27, 2011
    Manufacturer
    GAYMAR INDUSTRIES, INC.
    Product Code
    FMW
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Additional Manufacturer Narrative · 1

    SOILED.

    Description of Event or Problem · 1

    IT WAS REPORTED BY SERVICE REPORT THAT THE MATTRESS COVER WAS SOILED. NO PT INVOLVEMENT OR ADVERSE CONSEQUENCES ARE REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 XPRT MATTRESS W/O PENDANT MATTRESS FMW GAYMAR INDUSTRIES, INC. 2950200000 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK