MAUDE Adverse Event Report: Medline Industries, LP MEDLINE; LIFT,PAT,HYDRAULIC,6 POINT CRD,NO SLING

Catalog Number	MDS88200HL
Medical Device Problem Code	Fracture (1260)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	06/20/2024
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported that "they have two rear locking wheels and one non-locking caster that are defective" and "there is an issue with the bearings coming out and the casters are broken.".
Additional Manufacturer Narrative
The customer reported two rear locking wheels and one non-locking caster that are defective, with bearings coming out and the casters broken; the account reported this happened during patient use, and no medical intervention, serious injury, or follow-up care has been reported.A photo depicting the defect was provided and only a visual review of the defect could be conducted; the front casters appear to be loose due to the front casters and fork being unaligned with the stem cover, both front casters still appear to be attached to the lift base, and it also appears that a ball bearing has come off of one of the rear locking casters.The investigation results were confirmed.Given the evidence provided in the photo, the root cause of this issue is unknown, and the division will monitor through trending.There were no reports of death, serious injury, medical intervention, or follow up care.It has been determined that the reported event could cause or contribute to serious injury if it were to occur again.In an abundance of caution, this is a reportable event.If additional information becomes available this report will be reopened and reevaluated.This medical device report (mdr) is being submitted as part of retrospective review activities, which include review of historical data in accordance with regulations at 21 cfr part 803.The information included in this mdr reflects the information reasonably known to the manufacturer at the time of this retrospective review and submission.

• Brand Name: MEDLINE
• Common Device Name: LIFT,PAT,HYDRAULIC,6 POINT CRD,NO SLING
• Manufacturer (Section D): Medline Industries, LP; three lakes drive; northfield IL 60093 -275
• Manufacturer Contact: cyrus johnson ; three lakes drive; northfield, IL 60093--275
• MDR Report Key: 50774838
• Report Number: 1417592-2026-40767
• Device Sequence Number: 10445699
• Product Code: FSA
• UDI-Device Identifier: 40884389144825
• UDI-Public: 40884389144825
• Combination Product (Y/N): N
• Initial Reporter State: MS
• Initial Reporter Country: US
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Company Representative
• Type of Report: Initial
• Report Date (Section B): 09/10/2026

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 Catalogue Number: MDS88200HL
• Device Lot Number: H211230950
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: No
• Was the Report Sent to FDA?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 06/20/2024
• Initial Report FDA Received Date: 09/15/2026
• Was Device Evaluated by Manufacturer? (Y/N): No
• 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
• Patient Sequence Number: 1
• Patient Sex: Unknown