BEUDAMED
    FDA Adverse Event Death Summary report: N

    HOVERMATT

    MDR report key: 4449591 · Received December 22, 2014

    Report

    Report Number
    4449591
    Event Type
    Death
    Date Received
    December 22, 2014
    Date of Event
    November 20, 2014
    Report Date
    December 9, 2014
    Product Code
    FRZ
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PATIENT ON EXCEL CARE ES BARIATRIC BED WITH HOVERMATT DEFLATED UNDER PATIENT. PATIENT WAS SLEEPING AND REPORTED WHEN SHE WOKE UP HER LEG SLIDE OUT OF BED AND HER ENTIRE BODY SLIDE ON FLOOR. PATIENT HAD 3 SIDE RAILS UP AND HOVERMATT WAS UNDER HER ON FLOOR. PATIENT YELLED FOR HELP AND STAFF FOUND HER ON FLOOR. REFERENCE MFR # 2531468-2014-00001.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    843803 HOVERMATT DEVICE, PATIENT TRANSFER, POWERED FRZ

    Patients

    Seq Age Sex Outcome Treatment
    1 61 YR Death