Brand Name | BREEZE |
Type of Device | MATTRESS, AIR FLOTATION, ALTERNATING PRESSURE |
Manufacturer (Section D) |
ARJOHUNTLEIGH, A BRANCH OF ARJO LTD MED AB |
arjohuntleigh house |
houghton hall business park |
houghton regis, bedfordshire, LU5 5 XF |
TC LU5 5XF |
|
Manufacturer (Section G) |
ARJOHUNTLEIGH, A BRANCH OF ARJO LTD MED AB |
arjohuntleigh house |
houghton hall business park |
houghton regis, bedfordshire, LU5 5 XF |
TC
LU5 5XF
|
|
Manufacturer Contact |
kinga
stolinska
|
ul. ks. wawrzyniaka 2 |
komorniki, 62-05-2
|
PL
62-052
|
|
MDR Report Key | 8023131 |
MDR Text Key | 317026137 |
Report Number | 3007420694-2018-00208 |
Device Sequence Number | 1 |
Product Code |
FNM
|
Combination Product (y/n) | N |
Reporter Country Code | UK |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
User Facility,Company Representative |
Reporter Occupation |
Nurse
|
Type of Report
| Initial,Followup |
Report Date |
10/05/2018 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
No
|
Device Operator |
Other
|
Was Device Available for Evaluation? |
Yes
|
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
09/11/2018 |
Initial Date FDA Received | 10/31/2018 |
Supplement Dates Manufacturer Received | 09/11/2018
|
Supplement Dates FDA Received | 10/31/2018
|
Was Device Evaluated by Manufacturer? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Reuse
|
Patient Sequence Number | 1 |
Patient Outcome(s) |
Required Intervention;
|
Patient Age | 93 YR |
Patient Sex | Female |
|
|