FDA Adverse Event Malfunction Summary report: N

POSEY SITTER ELITE

MDR report key: 3994149 · Received July 24, 2014

Report

Report Number
2020362-2014-00249
Event Type
Malfunction
Date Received
July 24, 2014
Report Date
June 23, 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
ID, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

PRODUCT WAS REQUESTED TO BE RETURNED FOR EVAL AND HAS NOT BEEN RECEIVED. NOTE: THIS REPORT IS SUBMITTED BASED ON THE CUSTOMERS REPORTED ISSUE STATEMENT. (B)(4).

Description of Event or Problem · 1

CUSTOMER REPORTED WHEN THE NURSE CALL OPTION IS IN USE IT DOES NOT SEND A SIGNAL TO THE NURSE CALL STATION. ADDITIONALLY, THE HOLD BUTTON APPEARS TO BE JAMMED. THE DATE OF THE EVENT IS UNK. NO PT INCIDENT OR INJURY WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
433834 POSEY SITTER ELITE KMI J. T. POSEY CO. 8345 NA

Patients

Seq Age Sex Outcome Treatment
1 UNK NURSE CALL CABLE: MODEL 8282 LOT # UNK