FDA Adverse Event Malfunction Summary report: N

PRIME CARE (R) B900

MDR report key: 5846749 · Received May 7, 2014

Report

Report Number
2438477-2014-00040
Event Type
Malfunction
Date Received
May 7, 2014
Date of Event
April 15, 2014
Report Date
May 7, 2014
Manufacturer
PRIMUS MEDICAL, LLC
Product Code
FNL
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THIS BED FRAME HAS NOT BEEN INSPECTED YET DUE TO THE BED FRAME NOT BEING RETURNED YET. THE LOCATION OF WHERE THE ACTUATOR BROKE IS UNKNOWN AT THIS TIME. A NEW BED FRAME WAS SHIPPED OUT TO THE CUSTOMER ON 04/16/2014. THIS PROBLEM HAS BEEN ASSIGNED CAPA (B)(4), AND A FOLLOW-UP REPORT WILL BE SUBMITTED UPON COMPLETION OF THE CORRECTIVE ACTION.

Description of Event or Problem · 1

CUSTOMER CALLED IN SAYING THAT THEY HAD A WELD BREAK ON A BED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
277398 PRIME CARE (R) B900 FNL PRIMUS MEDICAL, LLC PCB900

Patients

Seq Age Sex Outcome Treatment
1