FDA Adverse Event Malfunction Summary report: N

NON AC-POWERED PATIENT LIFT

MDR report key: 2832648 · Received November 14, 2012

Report

Report Number
3004493922-2012-00468
Event Type
Malfunction
Date Received
November 14, 2012
Report Date
November 7, 2012
Manufacturer
INVACARE SUZHOU
Product Code
FSA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

(B)(4) NO RMA HAS BEEN INITIATED FOR THIS ISSUE. MODEL GHS350, SERIAL NUMBER/DATE CODE (B)(4) IS APPROXIMATELY TWO YEAR OLD. THE OWNER'S MANUAL PART NUMBER 1148115 REV. B (JUN-09) 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'S 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 AND THE MAINTENANCE HISTORY OF THE DEVICE ARE UNKNOWN. THE MALFUNCTION HAS NOT BEEN CONFIRMED.

Description of Event or Problem · 1

(B)(4) - THE DEALER REPORTED THAT THE GHS350 GET-UP LIFT FRONT HANDLE SCREW WAS BROKEN, AND THE SHAFT HOLE HAS WIDENED AND GETTING WEAK, POSING A RISK TO BREAK. THERE WAS NO PATIENT INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NON AC-POWERED PATIENT LIFT 880.5510 FSA INVACARE SUZHOU GSH350

Patients

Seq Age Sex Outcome Treatment
1 Other