MAUDE Adverse Event Report: HILL-ROM, INC. HOSPITAL BED; BED, AC-POWERED ADJUSTABLE HOSPITAL

Catalog Number 971405

Device Problems Smoking (1585); Sparking (2595)

Patient Problem No Information (3190)

Event Date 02/27/2017

Event Type  malfunction  

Event Description

Code red called at 2200.Er admit was brought to room.Bed was raised and lowered and cord into outlet at head of bed was not compromised at all.We were in room and all of a sudden there was a big pop and cloud of smoke and spark came from outlet.The cord to bed was in bottom prongs.

• Brand Name: HOSPITAL BED
• Type of Device: BED, AC-POWERED ADJUSTABLE HOSPITAL
• Manufacturer (Section D): HILL-ROM, INC.; 1069 state route 46 east; batesville IN 47006
• MDR Report Key: 6460625
• MDR Text Key: 71740871
• Report Number: 6460625
• Device Sequence Number: 1
• Product Code: FNL
• Combination Product (y/n): N
• Reporter Country Code: US
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: User Facility
• Reporter Occupation: Other
• Type of Report: Initial
• Report Date: 03/07/2017,03/10/2017

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 04/05/2017
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Nurse
• Device Catalogue Number: 971405
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: No
• Was the Report Sent to FDA?: Yes
• Date Report Sent to FDA: 03/07/2017
• Event Location: Hospital
• Date Report to Manufacturer: 03/07/2017
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: N
• Patient Sequence Number: 1
• Treatment: NO
• Patient Age: 73 YR