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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: HILL-ROM MEXICO FLAT DECK 36" MRS W/ X-RAY SLV; BED, FLOTATION THERAPY, POWERED

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HILL-ROM MEXICO FLAT DECK 36" MRS W/ X-RAY SLV; BED, FLOTATION THERAPY, POWERED Back to Search Results
Model Number P7924ARENT01
Medical Device Problem Code Material Split, Cut or Torn (4008)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/30/2024
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The baxter technician found the power cord needed to be replaced.The hillrom pro+ mattress is intended for patient support and for the prevention and/or treatment of pressure injuries.A search of the baxter maintenance records did not show baxter performed any preventative maintenance on this bed.It is unknown if the facility performs preventative maintenance on their beds.The technician replaced the power cord to resolve the reported event.Based on this information, no further action is required.
 
Event or Problem Description
Baxter received a report from a baxter technician stating the power cord had damage with exposed copper wires.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
FLAT DECK 36" MRS W/ X-RAY SLV
Common Device Name
BED, FLOTATION THERAPY, POWERED
Manufacturer (Section D)
HILL-ROM MEXICO
ave.del telefono no. 200 col. huinala
apodaca, nuevo leon 66640
MX  66640
Manufacturer Contact
brad wheeler
1069 state route 46 east
batesville, IN 47006
3128199307
MDR Report Key19954961
Report Number3006697241-2024-00078
Device Sequence Number8784453
Product Code IOQ
UDI-Device Identifier00887761976863
UDI-Public(01)00887761976863(11)210525
Combination Product (Y/N)N
Initial Reporter StateOK
Initial Reporter CountryUS
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source User Facility,Company Representative
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 08/09/2024
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 NumberP7924ARENT01
Was Device Available for Evaluation? Yes
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/30/2024
Initial Report FDA Received Date08/09/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured05/24/2021
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Reuse
Patient Sequence Number1
Patient SexUnknown
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