FDA Adverse Event Other Summary report: N

ELITE RISER

MDR report key: 3688127 · Received February 26, 2014

Report

Report Number
1931947-2014-00001
Event Type
Other
Date Received
February 26, 2014
Date of Event
February 7, 2014
Report Date
February 26, 2014
Manufacturer
NOA MEDICAL INDUSTRIES, INC.
Product Code
FNL
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

NO PRIOR HISTORY OF SIMILAR COMPLAINT SINCE MARKET INTRODUCTION FIVE YEARS AGO. TRENDING FOR SIMILAR COMPLAINTS IN THE FUTURE IS BEING PERFORMED. THERE IS NO FURTHER CORRECTIVE ACTION PLANNED AT THIS TIME.

Description of Event or Problem · 1

RESIDENT WAS SITTING IN WHEEL CHAIR FACING THE BED. SHE GRABBED THE ASSIST BAR TO PULL HERSELF UP WHEN THE HEAD OF THE BED ROSE AND SHE FELL BACK AWAY FROM THE BED. THE HEAD OF THE BED WAS SLIGHTLY ELEVATED WHEN SHE GRABBED THE ASSIST BAR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
119336 ELITE RISER AC POWERED ADJUSTABLE HOSPITAL BED FNL NOA MEDICAL INDUSTRIES, INC. 1050010BEI-T

Patients

Seq Age Sex Outcome Treatment
1 60 YR Other