BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    FGA 330 PORTABLE ALUMINUM LIFT 330 LBS

    MDR report key: 5143574 · Received October 11, 2015

    Report

    Report Number
    3007802293-2015-00041
    Event Type
    Malfunction
    Date Received
    October 11, 2015
    Date of Event
    September 17, 2015
    Report Date
    October 9, 2015
    Manufacturer
    PRISM MEDICAL
    Product Code
    FSA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Additional Manufacturer Narrative · 1

    THE FGA 330 PORTABLE ALUMINUM LIFT HAS NOT BEEN RECEIVED TO EVALUATE. FOLLOWING RECEIPT AND INVESTIGATION OF THE DEVICE, THIS REPORT WILL BE UPDATED.

    Description of Event or Problem · 1

    LEG WELDMENT BREAK REPORTED BY END USER AT ACTUATOR POST ON FGA 330 PORTABLE ALUMINUM LIFT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    674146 FGA 330 PORTABLE ALUMINUM LIFT 330 LBS FGA 330 LIFT FSA PRISM MEDICAL 280420

    Patients

    Seq Age Sex Outcome Treatment
    1