BEUDAMED
    FDA Adverse Event Death Summary report: N

    MATTRESS NYLEX II

    MDR report key: 490398 · Received October 16, 2003

    Report

    Report Number
    1417592-2003-00031
    Event Type
    Death
    Date Received
    October 16, 2003
    Date of Event
    September 30, 2003
    Report Date
    October 16, 2003
    Manufacturer
    MEDLINE INDUSTRIES, INC.
    Product Code
    FMW
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TN, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    THERE WAS A FIRE AT THE FACILITY THAT RESULTED IN ELEVEN DEATHS. PER LETTER RECEIVED THE FIRE MARSHAL DETERMINED THE FIRE STARTED IN THE BED/MATTRESS IN A ROOM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MATTRESS NYLEX II MATTRESS FMW MEDLINE INDUSTRIES, INC. MDT231280C NA

    Patients

    Seq Age Sex Outcome Treatment
    1 * Death