BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    NON AC-POWERED PATIENT LIFT

    MDR report key: 2931084 · Received January 28, 2013

    Report

    Report Number
    3004493922-2013-00193
    Event Type
    Malfunction
    Date Received
    January 28, 2013
    Date of Event
    December 28, 2012
    Report Date
    January 26, 2013
    Manufacturer
    INVACARE SUZHOU
    Product Code
    FSA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER STATES PUMP IS NOT STAYING UP. A REPLACEMENT PUMP HAS BEEN SENT. NO INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    36930 NON AC-POWERED PATIENT LIFT 880.5510 FSA INVACARE SUZHOU 9805

    Patients

    Seq Age Sex Outcome Treatment
    1 Other