BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    NON AC-POWERED PATIENT LIFT

    MDR report key: 2862555 · Received December 10, 2012

    Report

    Report Number
    1525712-2012-02767
    Event Type
    Malfunction
    Date Received
    December 10, 2012
    Date of Event
    November 6, 2012
    Report Date
    December 6, 2012
    Manufacturer
    UNKNOWN
    Product Code
    FSA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OR, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    (B)(4) IT WAS REPORTED BY THE CONSUMER THAT THE 6960-09 PATIENT LIFT OUT CHAIR HAND PENDANT CORD THAT GOES FROM THE MOTOR TO THE HAND PENDANT STARTED SMOKING WHILE IN USE. IT HAD NOT BEEN PLUGGED FOR 3 MONTHS, AND AFTER SMOKING, THE CORD WAS BURNT THRU. THERE WAS NO PATIENT INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 NON AC-POWERED PATIENT LIFT 880.5510 FSA UNKNOWN 6960-09

    Patients

    Seq Age Sex Outcome Treatment
    1 70 Other