FULL BODY SLING MESH MEDIUM 9153632093 R110

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 2014-12-22 for FULL BODY SLING MESH MEDIUM 9153632093 R110 manufactured by New Prokin.

Event Text Entries

[5141762] It has been reported by a provider that a r110 sling is ripping at the seams.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1531186-2014-06715
MDR Report Key4353103
Report Source*
Date Received2014-12-22
Date of Report2014-11-10
Date Facility Aware2014-11-10
Report Date2014-12-22
Date Reported to FDA2014-12-22
Date Reported to Mfgr2014-12-22
Date Added to Maude2014-12-22
Event Key0
Report Source CodeDistributor report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationMEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location0
Single Use0
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameFULL BODY SLING MESH MEDIUM 9153632093
Generic NameSLING, OVERHEAD SUSPENSION, WHEELCHAIR
Product CodeINE
Date Received2014-12-22
Model NumberR110
OperatorLAY USER/PATIENT
Device AvailabilityN
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerNEW PROKIN
Manufacturer AddressZHONGSHAN CH


Patients

Patient NumberTreatmentOutcomeDate
101. Deathisabilit 2014-12-22

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