FDA Adverse Event Malfunction Summary report: N

AC-POWERED ADJUSTABLE HOSPITAL BED, INCLUDING RAILS

MDR report key: 2882717 · Received December 20, 2012

Report

Report Number
3003433498-2012-00112
Event Type
Malfunction
Date Received
December 20, 2012
Report Date
December 19, 2012
Manufacturer
CARROLL HEALTHCARE
Product Code
FNL
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

A (B)(6) REPORTED THAT THE RESIDENT WAS LYING ON THE BED WHILE THE HEIGHT WAS BEING ADJUSTED WITH THE CONTROLLER AND THE ENTIRE BED COLLAPSED. IT WAS LEARNED THAT THE CRANK THAT GOES INTO THE MOTOR THAT CHANGES THE HEIGHT OF THE BED IS THE ISSUE. THE BED IS APPROX. 9 YEARS. OLD AND ONLY ONE RESIDENT USES THE BED DAILY. THE BED IS NOT PRESENTLY IN USE BUT REMAINS AT THE NURSING HOME. NO INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 AC-POWERED ADJUSTABLE HOSPITAL BED, INCLUDING RAILS 880.5100 FNL CARROLL HEALTHCARE SOLO

Patients

Seq Age Sex Outcome Treatment
1 Other