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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BAXTER HEALTHCARE CORPORATION THE VEST SYSTEM; PERCUSSOR, POWERED-ELECTRIC

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BAXTER HEALTHCARE CORPORATION THE VEST SYSTEM; PERCUSSOR, POWERED-ELECTRIC Back to Search Results
Model Number PR105
Medical Device Problem Code Sparking (2595)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/06/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The baxter technician found the device needed to be replaced.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 device to resolve the reported event.Based on this information, no further action is required.If any further information is received, the record will be reassessed as applicable.
 
Event or Problem Description
Baxter received a report from a baxter technician to report the vest model 105 serviced is sparking and smoking.The bed was located at the account.This occurred at home during patient use.There was no patient injury or death reported with this event.The reporter did not communicate this event to another baxter department or authority.
 
Additional Manufacturer Narrative
The baxter technician found the device needed to be replaced.The technician replaced the device to resolve the reported event.Based on this information, no further action is required.If any further information is received, the record will be reassessed as applicable.
 
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Brand Name
THE VEST SYSTEM
Common Device Name
PERCUSSOR, POWERED-ELECTRIC
Manufacturer (Section D)
BAXTER HEALTHCARE CORPORATION
deerfield IL
Manufacturer (Section G)
HILL-ROM ST. PAUL
1020 west county road f
st. paul MN 55126
Manufacturer Contact
25212 w. illinois route 120
round lake, IL 60073
2242702068
MDR Report Key22096178
Report Number2183816-2025-00030
Device Sequence Number7885778
Product Code BYI
UDI-Device Identifier00887761997776
UDI-Public00887761997776
Combination Product (Y/N)N
Initial Reporter StateOH
Initial Reporter CountryUS
PMA/510(K) Number
NA
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Consumer,Company Representative
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 08/20/2025
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
Device Model NumberPR105
Device Catalogue NumberPR105
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 05/06/2025
Supplement Date Received by Manufacturer08/19/2025
Initial Report FDA Received Date05/28/2025
Supplement Report FDA Received Date08/20/2025
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 Number1
Concomitant Medical Products
and Therapy/Usage Dates
N/A.
Patient SexUnknown
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