BEUDAMED
    FDA Adverse Event Death Summary report: N

    SEMI-ELECTRIC BED

    MDR report key: 2142445 · Received June 22, 2011

    Report

    Report Number
    1417592-2011-00034
    Event Type
    Death
    Date Received
    June 22, 2011
    Date of Event
    May 8, 2011
    Report Date
    June 14, 2011
    Manufacturer
    MEDLINE INDUSTRIES, INC.
    Product Code
    FNL
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TN, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    A WOMAN DIED AS A RESULT OF A FIRE THAT OCCURRED IN HER BEDROOM. SHE WAS FOUND IN HER BED. THE SAMPLE WAS NOT RETURNED FOR EVAL. THE SERIAL NUMBER WAS NOT PROVIDED. THE AGE OF BED IS APPROXIMATED TO BE 5-6 YRS. THE WOMAN HAD DEMENTIA, WAS A PREVIOUS SMOKER AND LIVED ALONE. AN OFFICIAL REPORT FROM THE FIRE MARSHAL HAS NOT BEEN RELEASED. INFO FROM THE LOCAL POLICE AND FIRE DEPARTMENTS INDICATED THAT THE WOMAN WAS FOUND WITH SEVERE BURNS TO THE UPPER HALF OF HER BODY. THE FIRE FIGHTER ON DUTY INDICATED THE FIRE SEEMED TO ORIGINATE AT THE HEAD OF THE BED. THE MOTORS/ELECTRONICS FOR THE BED ARE LOCATED AT THE FOOT SECTION. WE HAVE RECEIVED NO INFO TO SUGGEST THE BED CAUSED OR CONTRIBUTED TO THE FIRE. HOWEVER, DUE TO THE NATURE OF THE INCIDENT, AND IN AN ABUNDANCE OF CAUTION, THIS MEDWATCH IS BEING FILED.

    Description of Event or Problem · 1

    A FEMALE DIED IN BED AS A RESULT OF A FIRE THAT OCCURRED IN HER HOME. THE SOURCE OF THE FIRE HAS NOT BEEN IDENTIFIED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SEMI-ELECTRIC BED FNL MEDLINE INDUSTRIES, INC. MDR107002P UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 70 YR Death