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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER MEDICAL-KALAMAZOO ISOTOUR, 84 INCH,STD, END406; MATTRESS, FLOATATION THERAPY, NON-POWERED

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STRYKER MEDICAL-KALAMAZOO ISOTOUR, 84 INCH,STD, END406; MATTRESS, FLOATATION THERAPY, NON-POWERED Back to Search Results
Model Number 2872
Medical Device Problem Code Patient Device Interaction Problem (4001)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/01/2021
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
This record is a consolidation of records summarized as part of the fda voluntary malfunction summary reporting program.1 device is pending evaluation.There was no remedial action taken.This device is not labeled for single use.
 
Event or Problem Description
This report summarizes 1 malfunction event, where it was reported the device was too heavy/difficult to move.There was no patient involvement.
 
Additional Manufacturer Narrative
This supplemental is being filed to correct the common device name and product code in section b.Through communication/interviews with the user facility, the issue was not confirmed; no defect or malfunction was found.
 
Event or Problem Description
This report summarizes 1 malfunction event, where it was reported the device was too heavy/difficult to move.There was no patient involvement.
 
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Brand Name
ISOTOUR, 84 INCH,STD, END406
Common Device Name
MATTRESS, FLOATATION THERAPY, NON-POWERED
Manufacturer (Section D)
STRYKER MEDICAL-KALAMAZOO
3800 east centre avenue
portage MI 49002
MDR Report Key12234214
Report Number0001831750-2021-01082
Device Sequence Number3245114
Product Code IKY
UDI-Device Identifier07613327424638
UDI-Public07613327424638
Combination Product (Y/N)N
Initial Reporter StateMI
Initial Reporter CountryUS
Number of Events Summarized1
Summary Report (Y/N)Y
Reporter Type Manufacturer
Report Source company representative
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 09/07/2021
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 Number2872
Device Catalogue Number2872000012
Was Device Available for Evaluation? Yes
Initial Date Received by Manufacturer 07/01/2021
Supplement Date Received by Manufacturer07/01/2021
Initial Report FDA Received Date07/27/2021
Supplement Report FDA Received Date09/07/2021
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
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