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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BAXTER HEALTHCARE CORPORATION HILL-ROM 100 LOW BED; BED, AC-POWERED ADJUSTABLE HOSPITAL

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BAXTER HEALTHCARE CORPORATION HILL-ROM 100 LOW BED; BED, AC-POWERED ADJUSTABLE HOSPITAL Back to Search Results
Model Number P3930A
Medical Device Problem Code Material Split, Cut or Torn (4008)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/13/2025
Type of Reportable Event Malfunction
Event or Problem Description
Baxter received a report from a baxter technician to report the gpac frame-assembled power cord had copper wires exposed.The bed was located at the account.The process step during which this occurred was unknown.There was no patient/user injury, medical intervention, symptom, or adverse event reported.It was unknown if any second device was also involved.The customer did not know if this event was already communicated to another baxter department or authority.
 
Additional Manufacturer Narrative
The baxter technician found the power cord needed to be replaced.Per the baxter user manual: the hill-rom 1000 bed requires an effective maintenance program.We recommend that you perform annual preventive maintenance (pm) and testing for joint commission.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; this could occur if the plug blades have overheated or arced.Any signs of cracking; this could occur if the plug has been bent and straightened to a point past its useful life.Loose fit of the plug blade (the plug blade moves in the molding); this could occur if the molding has overheated or the blades have been bent and straightened to a point past their useful life.Any signs of damage to the cable.Any exposed wires.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.
 
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Brand Name
HILL-ROM 100 LOW 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 Key23780533
Report Number1824206-2025-02305
Device Sequence Number13288119
Product Code FNL
UDI-Device Identifier00887761000919
UDI-Public(01)00887761000919(11)250902
Combination Product (Y/N)N
Initial Reporter StateIN
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 Company Representative
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 12/11/2025
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 NumberP3930A
Device Catalogue NumberP3930A000026
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer11/13/2025
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 11/13/2025
Initial Report FDA Received Date12/11/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured09/02/2025
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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