BEUDAMED
    FDA Adverse Event Injury Summary report: N

    NURSE ASSIST

    MDR report key: 623847 · Received July 14, 2005

    Report

    Report Number
    623847
    Event Type
    Injury
    Date Received
    July 14, 2005
    Date of Event
    June 19, 2005
    Report Date
    July 14, 2005
    Manufacturer
    NURSE ASSIST, INC.
    Product Code
    KMI
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    FL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    WHEN NURSING STAFF ENTERED THE ROOM, THE PATIENT WAS FOUND ON THE FLOOR. THE BED ALARM WAS NOT ALARMING. THE BED ALARM WAS UNPLUGGED REVEALING, ONE OF THE UPPER PRONGS WAS LOOSE. THE PRONG SLIPPED BACK INTO THE BLACK POWER SUPPLY BOX.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 NURSE ASSIST BED EXIT ALARM KMI NURSE ASSIST, INC. M1000 *

    Patients

    Seq Age Sex Outcome Treatment
    1 83 YR Other| R