BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    AC-POWERED PATIENT LIFT

    MDR report key: 4143728 · Received October 6, 2014

    Report

    Report Number
    1525712-2014-06702
    Event Type
    Malfunction
    Date Received
    October 6, 2014
    Report Date
    September 17, 2014
    Manufacturer
    UNKNOWN
    Product Code
    FSA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NM, US
    Reporter Occupation
    PATIENT

    Narratives

    Additional Manufacturer Narrative · 1

    SERIAL NUMBER, (B)(4), IS OFF OF THE PUMP, NOT THE LIFT.

    Description of Event or Problem · 1

    THE END USER STATES THE PUMP IS MISSING TWO SCREWS AND WILL NOT HOLD.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    624680 AC-POWERED PATIENT LIFT 880.5500 FSA UNKNOWN 9805

    Patients

    Seq Age Sex Outcome Treatment
    1 Other