FDA Adverse Event Malfunction Summary report: N

POWERED PATIENT ROTATION BED

MDR report key: 2802250 · Received October 23, 2012

Report

Report Number
1525712-2012-01931
Event Type
Malfunction
Date Received
October 23, 2012
Report Date
October 22, 2012
Manufacturer
UNKNOWN
Product Code
IKZ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NV, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

(B)(4) NO RMA HAS BEEN INITIATED FOR THIS ISSUE. MODEL BED-3 (5310 BED PACKAGE), SERIAL NUMBER/DATE (B)(4) IS APPROXIMATELY 16 YEARS OLD. THE OWNER'S MANUAL PART NUMBER 1114836, 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 (B)(6). 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. THE MALFUNCTION HAS NOT BEEN CONFIRMED.

Description of Event or Problem · 1

DEALER CALLED STATING THAT THE 5310IVC BED (PART OF THE BED-3 BED PACKAGE) ALLEGEDLY STOPPED WORKING. THE TECHNICIAN FROM THE DEALERSHIP THAT CHECKED THE BED OUT ADVISED THAT INSIDE THE JUNCTION BOX IT LOOKED AS IF SOMETHING MELTED OR BURNED UP. REPLACEMENT PARTS ON QUOTE #(B)(4). NO INJURY

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 35 Other