BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    NON AC-POWERED PATIENT LIFT

    MDR report key: 3001800 · Received March 13, 2013

    Report

    Report Number
    3004493922-2013-00554
    Event Type
    Malfunction
    Date Received
    March 13, 2013
    Report Date
    February 11, 2013
    Manufacturer
    INVACARE SUZHOU
    Product Code
    FSA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    (B)(4). NO SERIOUS INJURY ALLEGED. MALFUNCTION ALLEGED. DEALER STATES THE SCREWS HAVE BROKEN. MDR FILED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    104878 NON AC-POWERED PATIENT LIFT 880.5510 FSA INVACARE SUZHOU ROZE

    Patients

    Seq Age Sex Outcome Treatment
    1 Other