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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: HILL-ROM BATESVILLE ENVELLA BED; BED, AIR FLUIDIZED

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HILL-ROM BATESVILLE ENVELLA BED; BED, AIR FLUIDIZED Back to Search Results
Model Number P0819A
Device Problem Smoking (1585)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 09/17/2022
Event Type  malfunction  
Manufacturer Narrative
The hillrom technician found some electrical burning at the power cord and needed replacement.The user manual instructs that power cords require inspection routinely to ensure no damage has occurred during use.The manuals also include warnings such as incorrect use or handling may result in damage to the power cord.They also instruct that if damage has occurred remove immediately, and to properly remove the power cord from the electrical outlet during transfer or movement of the device.A search of the hillrom maintenance records showed hillrom performed preventative maintenance on this bed in apr 12, 2022.It is unknown if the facility performed any other preventative maintenance on this bed.Hillrom technical support contacted the account who confirmed a repair was not wanted and requested the removal of the bed.Bed has been removed.Based on this information, no further action is required.
 
Event Description
Hillrom received a report from a hillrom technician stating the bed had burned wired smell and smoke came out of bed.The bed was located at the account.There was no patient/user injury reported.This report was filed in our complaint handling system as complaint # (b)(4).
 
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Brand Name
ENVELLA BED
Type of Device
BED, AIR FLUIDIZED
Manufacturer (Section D)
HILL-ROM BATESVILLE
1069 state route 46 east
batesville IN 47006
Manufacturer Contact
maritza valencia
1069 state route 46 east
batesville, IN 47006
8129310130
MDR Report Key15510669
MDR Text Key306354983
Report Number1824206-2022-00430
Device Sequence Number1
Product Code INX
UDI-Device Identifier00887761013834
UDI-Public010088776101383411180226
Combination Product (y/n)N
Reporter Country CodeUS
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type User Facility,Company Representative
Reporter Occupation Other
Type of Report Initial
Report Date 09/29/2022
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Model NumberP0819A
Was Device Available for Evaluation? Yes
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 09/17/2022
Initial Date FDA Received09/30/2022
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured02/20/2018
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Reuse
Patient Sequence Number1
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