BEUDAMED
    FDA Adverse Event Summary report: N

    DAILY ACTIVITY ASSIST DEVICES

    MDR report key: 2843125 · Received November 21, 2012

    Report

    Report Number
    1531186-2012-01428
    Date Received
    November 21, 2012
    Report Date
    November 19, 2012
    Manufacturer
    LERADO GLOBAL
    Product Code
    ILS
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SC, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER STATES 4 OF THE 2 SCREWS CAME UNDONE ON THE OVERBED TABLE. THE TABLE FELL ON END USER WHILE HE WAS IN BED. WHEN EXAMINING THE BED TABLE IT WAS FOUND TO HAVE LOOSE SCREWS AND SOME GLUE THAT WAS NOT HOLDING PROPERLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DAILY ACTIVITY ASSIST DEVICES 890.5050 ILS LERADO GLOBAL 6417

    Patients

    Seq Age Sex Outcome Treatment
    1 95 MO Other