BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    FULL ELECTRIC FOOT SPRING 9153638201

    MDR report key: 4883784 · Received July 1, 2015

    Report

    Report Number
    1031452-2015-14576
    Event Type
    Malfunction
    Date Received
    July 1, 2015
    Report Date
    June 4, 2015
    Manufacturer
    INVACARE FLORIDA OPERATIONS
    Product Code
    FNL
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Additional Manufacturer Narrative · 1

    FOLLOW UP TO BE SENT IF ADDITIONAL INFORMATION IS RECEIVED

    Description of Event or Problem · 1

    PROVIDER STATES: HEAD SPRING SECTION FROM BED AT PIVOT POINT HAS BROKEN FRAME, CAME APART.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    424326 FULL ELECTRIC FOOT SPRING 9153638201 BED, AC-POWERED ADJUSTABLE HOSPITAL FNL INVACARE FLORIDA OPERATIONS 5411IVC

    Patients

    Seq Age Sex Outcome Treatment
    1 Other