BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    NON AC-POWERED PATIENT LIFT

    MDR report key: 3171355 · Received June 14, 2013

    Report

    Report Number
    3007231105-2013-00035
    Event Type
    Malfunction
    Date Received
    June 14, 2013
    Report Date
    May 21, 2013
    Manufacturer
    AQUATEC OPERATIONS GMBH
    Product Code
    FSA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NM, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    CUSTOMER STATES THE BACK SEAT OF THE LIFT HAS A CRACK IN IT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    271255 NON AC-POWERED PATIENT LIFT 880.5510 FSA AQUATEC OPERATIONS GMBH H605

    Patients

    Seq Age Sex Outcome Treatment
    1 Other