FDA Adverse Event Malfunction Summary report: N

SITTER SELECT

MDR report key: 3770344 · Received February 18, 2014

Report

Report Number
2020362-2014-00048
Event Type
Malfunction
Date Received
February 18, 2014
Report Date
January 13, 2014
Manufacturer
J. T. POSEY CO.
Product Code
KMI
PMA / PMN Number
EXEMPT
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

RESULTS: EVAL OF THE RETURNED PRODUCT DID NOT CONFIRM THE REPORTED ISSUE, THE ALARM POWERS UP AND PASSES ALL FUNCTIONAL TESTS, THE ALARM SOUNDS AS IT SHOULD. HOWEVER, THE BATTERY SPRING TABS ARE BENT. CASE IS CHIPPED NEAR THE BATTERY DOOR. LIQUI-LABEL IS MISSING. (B)(4).

Description of Event or Problem · 1

CUSTOMER REPORTED THE ALARM HAS POWER BUT WILL NOT SOUND WHEN WEIGHT IS REMOVED FROM THE SENSOR. CUSTOMER DID NOT PROVIDE A DATE WHEN THIS ISSUE WAS DISCOVERED. NO PT INCIDENT OR INJURY WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
103482 SITTER SELECT KMI J. T. POSEY CO. 8361 NA

Patients

Seq Age Sex Outcome Treatment
1 UNK OVER-THE-MATTRESS SENSOR PAD, MODEL: 8307, LOT#UNK