BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CS BED 9153650455

    MDR report key: 4959541 · Received August 3, 2015

    Report

    Report Number
    3003433498-2015-00131
    Event Type
    Malfunction
    Date Received
    August 3, 2015
    Report Date
    July 9, 2015
    Manufacturer
    CARROLL HEALTHCARE
    Product Code
    FNL
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    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

    A WELD BROKE ON THE FOOT SECTION OF THE DECK, NOT OUT OF BOX, NO ADDITIONAL INFORMATION PROVIDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    504487 CS BED 9153650455 BED, AC-POWERED ADJUSTABLE HOSPITAL FNL CARROLL HEALTHCARE IHCS9FX

    Patients

    Seq Age Sex Outcome Treatment
    1 Other