BEUDAMED
    FDA Adverse Event Injury Summary report: N

    28Z AMBULANCE COT

    MDR report key: 4193808 · Received October 8, 2014

    Report

    Report Number
    1523574-2014-00020
    Event Type
    Injury
    Date Received
    October 8, 2014
    Date of Event
    September 4, 2014
    Report Date
    October 7, 2014
    Manufacturer
    FERNO-WASHINGTON, INC.
    Product Code
    FPO
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    THE COT WAS EVALUATED AND TESTED BY EMSAR, ON BEHALF OF THE MFR, ON (B)(6) 2014. THE UNIT WAS WEIGHT TESTED AND THE INCIDENT COULD NOT BE DUPLICATED. NO VISUAL MALFUNCTIONS WERE OBSERVED.

    Description of Event or Problem · 1

    CREW WAS PULLING COT FROM AMBULANCE. THEY SAW THE WHEELS GO DOWN BUT WERE UNSURE OF HEARING WHEELS LOCK. THEY STARTED TO PULL COT OUT AND THE COT AND PT LOWERED TO THE GROUND. PT HIT SIDE OF HEAD ON THE GROUND.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    632777 28Z AMBULANCE COT 28Z AMBULANCE COT FPO FERNO-WASHINGTON, INC. 0012805

    Patients

    Seq Age Sex Outcome Treatment
    1 68 YR Required Intervention