BEUDAMED
    FDA Adverse Event Summary report: N

    93H PROFLEXX AMBULANCE COT

    MDR report key: 6208374 · Received December 28, 2016

    Report

    Report Number
    1523574-2016-00039
    Date Received
    December 28, 2016
    Date of Event
    December 14, 2016
    Report Date
    December 23, 2016
    Manufacturer
    FERNO-WASHINGTON, INC.
    Product Code
    FPO
    UDI-DI
    00190790000394
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    EMERGENCY MEDICAL TECHNICIAN

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED AFTER LOADING A PATIENT ON THE COT THE MEDICS WERE ALLEGEDLY UNABLE TO RAISE THE COT TO THE TRANSPORT POSITION. THE CREW CALLED ANOTHER MEDIC UNIT TOR TRANSPORT OF THE PATIENT ON ANOTHER COT. THERE WAS NO REPORT OF INJURY OR ADVERSE CONSEQUENCE TO THE PATIENT. THE UNDERCARRIAGE OF THE SUBJECT COT WAS ABLE TO BE EXTENDED WITH FORCE SO IT COULD BE TRANSPORTED BACK TO THE STATION. A FIELD TECHNICIAN WAS ONSITE WHEN THE COT WAS RETURNED TO THE STATION. THE COT WAS EVALUATED AND IT WAS FOUND A WASHER WAS MISSING FROM THE FOOT END COVER PLATE WHICH ALLOWED THE SCREW TO POKE DOWN TOO FAR AND IMPEDE THE TRAVEL OF THE ROLLER. THE MISSING WASHER WAS FOUND TO BE AN OVERSIGHT FROM A PREVIOUS PM SERVICE CONDUCTED ON 12/7/2016. THE WASHER WAS INSTALLED AND THE COT WAS TESTED FOR ALL FUNCTIONS AND RETURNED TO SERVICE ON THE SAME DAY AS THE REPORTED INCIDENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    858806 93H PROFLEXX AMBULANCE COT 93H PROFLEXX AMBULANCE COT FPO FERNO-WASHINGTON, INC. 0015757 00190790000394

    Patients

    Seq Age Sex Outcome Treatment
    1