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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: HILLROM DE MEXICO S DE RL DE CV ADVANTA BED; A/C POWERED ADJUSTABLE HOSPITAL BED
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HILLROM DE MEXICO S DE RL DE CV ADVANTA BED; A/C POWERED ADJUSTABLE HOSPITAL BED Back to Search Results
Model Number 1190
Device Problem Sticking (1597)
Patient Problem No Known Impact Or Consequence To Patient (2692)
Event Date 12/23/2014
Event Type  malfunction  
Event Description
Hill-rom received a report from the account stating the head section would not lower when cpr lever was used.The bed was located in room 427 at the account.There was no pt/user injury reported.This report was filed in our complaint handling system as complaint #(b)(4).
 
Manufacturer Narrative
The account requested a hill-rom tech to repair and then cancelled that request.It is unk if the facility performs preventative maintenance on their beds.The account stated the bed is repaired, but did not provide any info or details.Based on this info, no further action is required.
 
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Brand Name
ADVANTA BED
Type of Device
A/C POWERED ADJUSTABLE HOSPITAL BED
Manufacturer (Section D)
HILLROM DE MEXICO S DE RL DE CV
apodaca
MX 
Manufacturer Contact
tony werner
1069 state route 46 east
batesville, IN 47006
8129312359
MDR Report Key4459072
MDR Text Key16989999
Report Number3006697241-2015-00024
Device Sequence Number1
Product Code FNL
Combination Product (y/n)N
Reporter Country CodeUS
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type User Facility
Reporter Occupation Unknown
Type of Report Initial
Report Date 12/23/2014
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received01/20/2015
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Other
Device Model Number1190
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Date Manufacturer Received12/23/2014
Was Device Evaluated by Manufacturer? Yes
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Unknown
Patient Sequence Number1
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