MAUDE Adverse Event Report: MOXI MAXI LAL 36X80 MATTRESS, LAL CONTROL UNIT; MATTRESS, AIR FLOTATION, ALTERNATING PRESSURE

Device Problem Insufficient Information (3190)

Patient Problem Fall (1848)

Event Date 04/11/2019

Event Type  Injury  

Event Description

Per velvet scott,pt patient fell out the bed and injured himself today (b)(6) 2019 at 2:30pm.He was transferred to the emergency room due to injury from fall.This report reflects information received by fda in the form of a notification per 803.22 (b)(2).

• Brand Name: MAXI LAL 36X80 MATTRESS, LAL CONTROL UNIT
• Type of Device: MATTRESS, AIR FLOTATION, ALTERNATING PRESSURE
• Manufacturer (Section D): MOXI
• MDR Report Key: 17536330
• MDR Text Key: 321151680
• Report Number: MW5143218
• 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: 04/29/2019

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