FDA Adverse Event
Malfunction
Summary report: N
3 MOTOR ADVANCE BED
MDR report key: 2212890
·
Received July 12, 2011
Report
- Report Number
- 1824206-2011-03679
- Event Type
- Malfunction
- Date Received
- July 12, 2011
- Date of Event
- May 19, 2011
- Report Date
- May 19, 2011
- Manufacturer
- HILL-ROM, INC.
- Product Code
- FNL
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
THE TECHNICIAN FOUND THE BRAKE BLOCK ASSEMBLY WAS BROKEN AND THE CASTERS WERE RUSTED. HE REPLACED THE BRAKE BLOCK ASSEMBLY AND THE FOUR CASTERS TO REPAIR THE BED.
Description of Event or Problem · 1
INFORMATION RECEIVED INDICATES THE BRAKE IS NOT HOLDING.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | 3 MOTOR ADVANCE BED | AC-POWERED ADJUSTABLE HOSPITAL BED | FNL | HILL-ROM, INC. | 1130 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |