FDA Adverse Event Malfunction Summary report: N

POWERED PATIENT ROTATION BED

MDR report key: 2489021 · Received March 13, 2012

Report

Report Number
1031452-2012-00029
Event Type
Malfunction
Date Received
March 13, 2012
Date of Event
February 28, 2012
Report Date
March 12, 2012
Manufacturer
INVACARE FLORIDA OPERATIONS
Product Code
IKZ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PATIENT FAMILY MEMBER OR FRIEND

Narratives

Additional Manufacturer Narrative · 1

NO RMA HAS BEEN INITIATED FOR THIS ISSUE. MODEL 5310IVC, SERIAL NUMBER/DATE CODE (B)(4) IS APPROXIMATELY 2 YEARS OLD. THE OWNER'S MANUAL PART NUMBER 1114836 REV F ((B)(4) WAS ISSUED WITH THIS DEVICE. THE OWNER'S MANUAL IS ALSO FOUND ON-LINE AT INVACARE.COM. IT IS UNKNOWN IF THE CONSUMER HAS FULLY READ AND UNDERSTANDS THE OWNER'S MANUAL. DOCUMENTATION PROVIDES WARNINGS, CAUTIONS, AND INSTRUCTIONS FOR SAFELY USING THE DEVICE. IF THE CONSUMER DOES NOT UNDERSTAND THE WRITTEN WARNINGS, CAUTIONS OR INSTRUCTIONS THEN THEY SHOULD CONTACT INVACARE. THE CONSUMER IS A MALE WHOSE AGE, HEIGHT AND WEIGHT ARE UNKNOWN. THE CONSUMER'S MEDICAL CONDITION, STABILITY AND MEDICATION REGIMEN ARE UNKNOWN. THE CONSUMER'S TECHNIQUE WHILE USING THE DEVICE IS UNKNOWN. THE MAINTENANCE HISTORY OF THE DEVICE IS UNKNOWN.

Description of Event or Problem · 1

CONSUMER STATED THAT ALLEGEDLY THERE WAS A SPARK FROM THE CORD AT THE OUTLET. NO INJURY ALLEGED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 POWERED PATIENT ROTATION BED 890.5225 IKZ INVACARE FLORIDA OPERATIONS 5310IVC

Patients

Seq Age Sex Outcome Treatment
1 Other