MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a * report with the FDA on 2014-10-24 for MATTRESS COVER FOR MEDICAL PURPOSES CG9701 manufactured by Grand Healthcare Co., Ltd..
[4960497]
It has been reported that a cg9701 mattress has deflated in the middle, and when patient is moved to another section, it will also deflate.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1531186-2014-05067 |
| MDR Report Key | 4199418 |
| Report Source | * |
| Date Received | 2014-10-24 |
| Date of Report | 2014-09-08 |
| Date Facility Aware | 2014-09-08 |
| Report Date | 2014-10-24 |
| Date Reported to FDA | 2014-10-24 |
| Date Reported to Mfgr | 2014-10-24 |
| Date Added to Maude | 2014-10-24 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | PATIENT |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 0 |
| Single Use | 0 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | MATTRESS COVER FOR MEDICAL PURPOSES |
| Generic Name | 880.6190 |
| Product Code | FMW |
| Date Received | 2014-10-24 |
| Model Number | CG9701 |
| Operator | LAY USER/PATIENT |
| Device Availability | N |
| Device Age | 3 MO |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | GRAND HEALTHCARE CO., LTD. |
| Manufacturer Address | 4F, NO. 49, SEC.2 JEN AI ROAD TAIPEI TW |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2014-10-24 |