BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    NON AC-POWERED PATIENT LIFT

    MDR report key: 4143729 · Received October 6, 2014

    Report

    Report Number
    3007231105-2014-00065
    Event Type
    Malfunction
    Date Received
    October 6, 2014
    Report Date
    September 17, 2014
    Manufacturer
    AQUATEC OPERATIONS GMBH
    Product Code
    FSA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER ALLEGES, AQUATEC F PLASTIC BOLTS /PINS BROKEN ON BACK PART NEEDED TO HOLD BACK IN PLACE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    624143 NON AC-POWERED PATIENT LIFT 880.5510 FSA AQUATEC OPERATIONS GMBH 1471198

    Patients

    Seq Age Sex Outcome Treatment
    1 Other