3 POSITION RECLINER-BASIC BLUE RIDGE 9153641336 IH6074A/IH61

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a * report with the FDA on 2014-12-19 for 3 POSITION RECLINER-BASIC BLUE RIDGE 9153641336 IH6074A/IH61 manufactured by Goodbaby.

Event Text Entries

[15319265] It has been reported that the position lock lever on a ih6074/ih61 recliner is broken.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1531186-2014-06499
MDR Report Key4344529
Report Source*
Date Received2014-12-19
Date of Report2014-11-04
Date of Event2014-08-01
Date Facility Aware2014-11-04
Report Date2014-12-17
Date Reported to FDA2014-12-17
Date Reported to Mfgr2014-12-17
Date Added to Maude2014-12-19
Event Key0
Report Source CodeDistributor report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER CAREGIVERS
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location0
Single Use0
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand Name3 POSITION RECLINER-BASIC BLUE RIDGE 9153641336
Generic NameCHAIR AND TABLE, MEDICAL
Product CodeKMN
Date Received2014-12-19
Model NumberIH6074A/IH61
OperatorLAY USER/PATIENT
Device AvailabilityN
Device Age3 YR
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerGOODBABY
Manufacturer AddressCH


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2014-12-19

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