FDA Adverse Event Other Summary report: N

EASY CARE ELECTRIC BED

MDR report key: 3177563 · Received June 13, 2013

Report

Report Number
3009402404-2013-00032
Event Type
Other
Date Received
June 13, 2013
Date of Event
June 8, 2013
Report Date
June 13, 2013
Manufacturer
JOERNS HEALTHCARE
Product Code
FNL
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NH, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

JOERNS SENDING THE REPORT TO THE MANUFACTURER.

Description of Event or Problem · 1

IT WAS REPORTED TO THE MANUFACTURER BY THE FACILITY ((B)(6)), PER THE FACILITY THE CLIP THAT HOLDS THE FRAME BROKE AND LET GO. THE PRESSURE FROM THE PISTON DROVE IT FORWARD CAUSING DAMAGE TO THE FRAME AND A BENT MOTOR. THE HEAD PORTION OF THE BED FELL. THE RESIDENT WAS IN THE BED WHEN THE EVENT OCCURRED, BUT WAS NOT INJURED. (B)(4) HAS BEEN ENTERED INTO OUR SYSTEM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
268751 EASY CARE ELECTRIC BED PT HOSPITAL BED FNL JOERNS HEALTHCARE ECS3

Patients

Seq Age Sex Outcome Treatment
1 89 YR