FDA Adverse Event Malfunction Summary report: N

1031452-2016-03262

MDR report key: 5865609 · Received August 10, 2016

Report

Report Number
1031452-2016-03262
Event Type
Malfunction
Date Received
August 10, 2016
Report Date
August 31, 2016
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL/UPDATED INFORMATION WAS ADDED TO REFLECT THE JUNCTION BOX BEING RETURNED TO THE MANUFACTURER FOR EVALUATION. THE RESULT OF THE EVALUATION WAS THAT NO SMOKE OR SPARKS WERE OBSERVED DURING TESTING. HOWEVER, IT WAS EVIDENT THAT THE JUNCTION BOX HAD FAILED AS THERE WAS DAMAGE TO THE C2 CAPACITOR AND THE K3/K6 RELAYS WERE EXPOSED. THE UNDERLYING CAUSE COULD NOT BE DETERMINED.

Additional Manufacturer Narrative · 1

A RETURN WAS ISSUED AND THE PRODUCT IS AWAITING RECEIPT AND/OR EVALUATION. A FOLLOW UP WILL BE FILED IF/WHEN ANY ADDITIONAL INFORMATION IS PROVIDED.

Description of Event or Problem · 1

AN ELECTRICAL COMPONENT OF THE BED WAS SMOKING AND FLAMING.

Description of Event or Problem · 1

AN ELECTRICAL COMPONENT OF THE BED WAS SMOKING AND FLAMING.

Patients

Seq Age Sex Outcome Treatment
1