MAUDE Adverse Event Report: STRYKER MEDICAL-KALAMAZOO FLORENCE DC W/REGULAR SIDERAIL; BED, AC-POWERED ADJUSTABLE HOSPITAL

Catalog Number	FL23SE-STD
Medical Device Problem Code	Unintended System Motion (1430)
Health Effect - Clinical Code	No Patient Involvement (2645)
Date of Event	10/01/2018
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
This mdr is part of the fda voluntary malfunction summary reporting program.The device was evaluated in the field but the issue was not confirmed; no defect or malfunction was found.There was no remedial action taken.This device is not labeled for single use.
Event or Problem Description
This report summarizes 1 malfunction event, where it was reported there was phantom lift motion.There was no patient involvement.
Additional Manufacturer Narrative
This product was manufactured by umano medical.
Event or Problem Description
This report summarizes 1 malfunction event, where it was reported there was phantom lift motion.There was no patient involvement.

• Brand Name: FLORENCE DC W/REGULAR SIDERAIL
• Common Device Name: BED, AC-POWERED ADJUSTABLE HOSPITAL
• Manufacturer (Section D): STRYKER MEDICAL-KALAMAZOO; 3800 east centre avenue; portage MI 49002
• MDR Report Key: 8279091
• Report Number: 0001831750-2019-00035
• Device Sequence Number: 11334088
• Product Code: FNL
• UDI-Device Identifier: 00670482000043
• UDI-Public: 00670482000043
• Combination Product (Y/N): N
• Initial Reporter State: MI
• Initial Reporter Country: US
• Number of Events Summarized: 1
• Summary Report (Y/N): Y
• Reporter Type: Manufacturer
• Report Source: company representative
• Initial Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date (Section B): 04/25/2019

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: No Information
• Device Catalogue Number: FL23SE-STD
• Was Device Available for Evaluation?: Yes
• Initial Date Received by Manufacturer: 01/01/2019
• Supplement Date Received by Manufacturer: 01/01/2019
• Initial Report FDA Received Date: 01/25/2019
• Supplement Report FDA Received Date: 04/25/2019
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1