MAUDE Adverse Event Report: BAXTER HEALTHCARE CORPORATION VERSACARE MED SURG BED; BED, AC-POWERED ADJUSTABLE HOSPITAL

Model Number	P3201D
Medical Device Problem Code	Sparking (2595)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	09/16/2024
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
No further information is available on the repair of the bed at this time.The investigation is ongoing, however if any additional relevant information is identified following completion of the investigation, the additional relevant information will be submitted in a supplemental report.
Event or Problem Description
It was reported that sparks are coming from the near side of the head caster.The bed was located at the account.There was no patient/user injury reported.
Additional Manufacturer Narrative
The baxter technician found the power cord needed to be replaced.Per the baxter service manual, perform annual preventive maintenance procedures to make sure all versacare bed components are functioning as originally designed.Examine the plug for damage.Make sure the plug is a one-piece molded plug assembly.If it is not, replace the plug cord assembly.Replace any plug cord assembly that shows any of these: discoloration of the plug molding, around the plug blades.Any signs of cracking., loose fit of the plug blade (the plug blade moves in the molding), verify that the strain relief p-clip is present.Replace the power cord, if damaged.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
It was reported that sparks are coming from the near side of the head caster.The bed was located at the account.There was no patient/user injury reported.

• Brand Name: VERSACARE MED SURG BED
• Common Device Name: BED, AC-POWERED ADJUSTABLE HOSPITAL
• Manufacturer (Section D): BAXTER HEALTHCARE CORPORATION; deerfield IL
• Manufacturer (Section G): HILL-ROM BATESVILLE; 1069 state route 46 east; batesville IN 47006
• Manufacturer Contact: 25212 w. illinois route 120; round lake, IL 60073 ; 2242702068
• MDR Report Key: 20457493
• Report Number: 1824206-2024-01459
• Device Sequence Number: 7765813
• Product Code: FNL
• UDI-Device Identifier: 00887761000889
• UDI-Public: (01)00887761000889(11)060823
• Combination Product (Y/N): N
• Initial Reporter Country: JA
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Foreign,Company Representative
• Initial Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date (Section B): 04/16/2025

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: Other
• Device Model Number: P3201D
• Device Catalogue Number: P3201D000087
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 09/16/2024
• Supplement Date Received by Manufacturer: 04/14/2025
• Initial Report FDA Received Date: 10/15/2024
• Supplement Report FDA Received Date: 04/16/2025
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• 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 Number: 1
• Patient Sex: Unknown