FDA Adverse Event Malfunction Summary report: N

MAXI LITE

MDR report key: 3110551 · Received April 11, 2013

Report

Report Number
9681684-2013-00034
Event Type
Malfunction
Date Received
April 11, 2013
Manufacturer
ARJOHUNTLEIGH MAGOG INC
Product Code
FSA
Report Source
Manufacturer report

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT IS BEING FILED UNDER EXEMPTION (B)(4) BY ARJOHUNTLEIGH INC., ON BEHALF OF THE MANUFACTURER (B)(4). THE DEVICE WAS INSPECTED ON-SITE BY A REPRESENTATIVE OF THE MANUFACTURER'S SALES AND SERVICE UNIT SUBSIDIARY DIVISION, NOT A DIRECT EMPLOYEE OF THE MANUFACTURER. ADDITIONAL INFORMATION WILL BE PROVIDED FOLLOWING THE CONCLUSION OF THE MANUFACTURER'S INVESTIGATION.

Description of Event or Problem · 1

(B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
154792 MAXI LITE MANUFACTURED FLOOR PASSIVE LIFT FSA ARJOHUNTLEIGH MAGOG INC

Patients

Seq Age Sex Outcome Treatment
1