MAUDE Adverse Event Report: MOXI SA48MATT, BARI SELECT; MATTRESS, AIR FLOTATION, ALTERNATING PRESSURE

Device Problem Insufficient Information (3190)

Patient Problem Fall (1848)

Event Date 10/19/2019

Event Type  Injury  

Event Description

Patient slide fall off of the mattress.The patient just called out for help and the nurses went in to see on the floor.This report reflects information received by fda in the form of a notification per 803.22 (b)(2).

• Brand Name: SA48MATT, BARI SELECT
• Type of Device: MATTRESS, AIR FLOTATION, ALTERNATING PRESSURE
• Manufacturer (Section D): MOXI
• MDR Report Key: 17531773
• MDR Text Key: 321136653
• Report Number: MW5138685
• Device Sequence Number: 1
• Product Code: FNM
• Combination Product (y/n): N
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Voluntary
• Reporter Occupation: Other
• Type of Report: Initial
• Report Date: 11/22/2019

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 08/12/2023
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: No
• Patient Sequence Number: 1