AIRPAL PATIENT TRANSFER SYSTEM 037SPS

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2012-06-13 for AIRPAL PATIENT TRANSFER SYSTEM 037SPS manufactured by Patient Transfer Systems, Inc..

Event Text Entries

[2766989] The patient transfer mat handles pulled out of the mat and deflated the mat.
Patient Sequence No: 1, Text Type: D, B5

MAUDE Entry Details

• Report Number: 2622055
• MDR Report Key: 2622055
• Date Received: 2012-06-13
• Date of Report: 2012-06-13
• Date of Event: 2012-04-18
• Report Date: 2012-06-13
• Date Reported to FDA: 2012-06-13
• Date Added to Maude: 2012-06-19
• Event Key: 0
• Report Source Code: User Facility report
• Manufacturer Link: N
• Number of Patients in Event: 0
• Adverse Event Flag: 3
• Product Problem Flag: 3
• Reprocessed and Reused Flag: 0
• Health Professional: 3
• Initial Report to FDA: 3
• Report to FDA: 3
• Event Location: 3
• Single Use: 0
• Previous Use Code: 0
• Event Type: 3
• Type of Report: 3

Device Details

• Brand Name: AIRPAL PATIENT TRANSFER SYSTEM
• Generic Name: PATIENT TRANSFER MAT.
• Product Code: FRZ
• Date Received: 2012-06-13
• Model Number: 037SPS
• Catalog Number: 037SPS
• Lot Number: *
• ID Number: *
• Operator: OTHER
• Device Availability: N
• Device Age: 1 MO OLD
• Device Sequence No: 1
• Device Event Key: 0
• Manufacturer: PATIENT TRANSFER SYSTEMS, INC.
• Manufacturer Address: 1488 LIMEPORT PIKE COOPERSBURG PA 18036 US 18036

Patients

Patient Number	Treatment	Outcome	Date
1	0		2012-06-13