MAUDE Adverse Event Report: TRIDIEN TRIDIEN APL MATTRESS; MATTRESS, AIR FLOTATION, ALTERNATING PRESSURE

Model Number TRIDIEN STAT 5000AP CONTROL UNIT, APL 36X80 MATTRESS 5000C, 3001020

Device Problem Adverse Event Without Identified Device or Use Problem (2993)

Patient Problem Fall (1848)

Event Date 09/25/2017

Event Type  Injury  

Event Description

Per truly the patient was lying on mattress and just slide out to the floor.The service ticket (pickup) is (b)(4).No injuries specified.This report reflects information received by fda in the form of a notification per 803.22 (b)(2).

• Brand Name: TRIDIEN APL MATTRESS
• Type of Device: MATTRESS, AIR FLOTATION, ALTERNATING PRESSURE
• Manufacturer (Section D): TRIDIEN
• MDR Report Key: 17536430
• MDR Text Key: 321093414
• Report Number: MW5143318
• 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: 10/04/2017

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
• Device Model Number: TRIDIEN STAT 5000AP CONTROL UNIT, APL 36X80 MATTRESS 5000C, 3001020
• Patient Sequence Number: 1
• Patient Age: 67 YR