BEUDAMED
    FDA Adverse Event Injury Summary report: N

    35A AMBULANCE COT

    MDR report key: 4066325 · Received August 26, 2014

    Report

    Report Number
    1523574-2014-00017
    Event Type
    Injury
    Date Received
    August 26, 2014
    Date of Event
    July 13, 2014
    Report Date
    August 25, 2014
    Manufacturer
    FERNO-WASHINGTON, INC.
    Product Code
    FPO
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    VA, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    THE DEVICE WAS EVALUATED ON (B)(4) 2014 BY (B)(4), ON BEHALF OF THE MFR. NO DEFECTS OR MALFUNCTIONS COULD BE FOUND. THE INCIDENT COULD NOT BE DUPLICATED. THE UNIT WAS OPERATING ACCORDING TO SPECIFICATIONS. NO FURTHER INFO WAS PROVIDED TO MFR PERTAINING TO PT INJURY AND/OR MEDICAL TREATMENT SOUGHT OUTSIDE OF THE ORIGINAL REASON FOR DISPATCH.

    Description of Event or Problem · 1

    PT WAS WALKED WITH ASSISTANCE TO THE STRETCHER. STRETCHER AS APPROX 1 FT FROM FLOOR. WHEN PT SAT ON SIDE OF STRETCHER WITH HIS FEET STILL ON THE FLOOR, THE UNIT LOWERED TO FLOOR LEVEL. PT INDICATED THAT IT AGGRAVATED HIS LOWER BACK PAIN, BUT HAD NO OTHER COMPLAINTS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    515558 35A AMBULANCE COT 35A AMBULANCE COT FPO FERNO-WASHINGTON, INC. 0012079

    Patients

    Seq Age Sex Outcome Treatment
    1 88 YR Other