BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ERGOLINE

    MDR report key: 3833613 · Received May 21, 2014

    Report

    Report Number
    9615023-2014-00001
    Event Type
    Malfunction
    Date Received
    May 21, 2014
    Date of Event
    May 16, 2014
    Report Date
    May 20, 2014
    Manufacturer
    JK PRODUCTS GMBH
    Product Code
    LEJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OK, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    CLAIMANT ALLEGES BED CAUGHT FIRE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    301474 ERGOLINE ESPIRT LEJ JK PRODUCTS GMBH 770

    Patients

    Seq Age Sex Outcome Treatment
    1