MAUDE Adverse Event Report: Medline Industries, LP Medline; DBD-BED, LOW FULL ELECTRIC, BASIC

Catalog Number	MDR107003ELO
Medical Device Problem Code	Detachment of Device or Device Component (2907)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	09/04/2026
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported that the head portion of the bed wasn't working, the motor fell off from where it was mounted on the bed.
Additional Manufacturer Narrative
It was reported that the head portion of the bed wasn't working, the motor fell off from where it was mounted on the bed.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.

• Brand Name: Medline
• Common Device Name: DBD-BED, LOW FULL ELECTRIC, BASIC
• Manufacturer (Section D): Medline Industries, LP; three lakes drive; northfield 60093
• Manufacturer Contact: jeffrey johnson ; three lakes drive; northfield 60093
• MDR Report Key: 50913216
• Report Number: 1417592-2026-51788
• Device Sequence Number: 5753053
• Product Code: LLI
• UDI-Device Identifier: 10080196546992
• UDI-Public: 10080196546992
• Combination Product (Y/N): N
• Initial Reporter State: MN
• Initial Reporter Country: US
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Y
• Reporter Type: Manufacturer
• Report Source: Health Professional
• Type of Report: Initial
• Report Date (Section B): 09/28/2026

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: MDR107003ELO
• 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: 09/04/2026
• Initial Report FDA Received Date: 09/28/2026
• Was Device Evaluated by Manufacturer? (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 Age: 86 YR
• Patient Sex: Male
• Patient Weight: 222 LB