BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SM104 MSERIES W/ 5TH WHEEL

    MDR report key: 2933541 · Received December 21, 2012

    Report

    Report Number
    1831750-2012-13285
    Event Type
    Malfunction
    Date Received
    December 21, 2012
    Date of Event
    November 29, 2012
    Report Date
    November 29, 2012
    Manufacturer
    STRYKER MEDICAL
    Product Code
    FPO
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Additional Manufacturer Narrative · 1

    IV POLE.

    Description of Event or Problem · 1

    IT WAS REPORTED BY SERVICE REPORT THAT THE SIDERAIL WOULD NOT LATCH IN THE UPRIGHT POSITION, THE BRAKES WERE NOT HOLDING AND THE IV POLE WAS DAMAGED. NO PT INVOLVEMENT OR ADVERSE CONSEQUENCES WERE REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SM104 MSERIES W/ 5TH WHEEL HOSPITAL WHEELED STRETCHER FPO STRYKER MEDICAL 1007 NA

    Patients

    Seq Age Sex Outcome Treatment
    1