MAUDE Adverse Event Report: STRYKER MEDICAL-KALAMAZOO SECURE CONNECT LOCATOR; BED, AC-POWERED ADJUSTABLE HOSPITAL

Model Number	521200380100
Medical Device Problem Code	Electrical /Electronic Property Problem (1198)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	05/10/2021
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported the charging brick for the secure connect locator broke off at the power prongs after being bumped, leading to accessible ac current.There are no reports of patient involvement or adverse consequences.

• Brand Name: SECURE CONNECT LOCATOR
• Common Device Name: BED, AC-POWERED ADJUSTABLE HOSPITAL
• Manufacturer (Section D): STRYKER MEDICAL-KALAMAZOO; 3800 east centre avenue; portage MI 49002
• MDR Report Key: 11940857
• Report Number: 0001831750-2021-00937
• Device Sequence Number: 11790521
• Product Code: FNL
• UDI-Device Identifier: 07613327520453
• UDI-Public: 07613327520453
• Combination Product (Y/N): N
• Initial Reporter State: KY
• Initial Reporter Country: US
• PMA/510(K) Number: K103536
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: user facility
• Initial Reporter Occupation: Other
• Type of Report: Initial
• Report Date (Section B): 06/04/2021

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
• Operator of Device: No Information
• Device Model Number: 521200380100
• Device Catalogue Number: 521200380100
• Was Device Available for Evaluation?: Yes
• Type of Report(Section G): Initial
• Initial Date Received by Manufacturer: 05/10/2021
• Initial Report FDA Received Date: 06/04/2021
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1