3 POSITION RECLINER BASIC ROSEWOOD 9153641231 IH6074A/IH60

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 2015-01-12 for 3 POSITION RECLINER BASIC ROSEWOOD 9153641231 IH6074A/IH60 manufactured by Goodbaby.

Event Text Entries

[5309445] Dealer is stating that the foot rest is not laying correctly.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1531186-2015-00165
MDR Report Key4406878
Report Source*
Date Received2015-01-12
Date of Report2014-12-22
Date Facility Aware2014-12-22
Report Date2015-01-09
Date Reported to FDA2015-01-09
Date Reported to Mfgr2015-01-09
Date Added to Maude2015-01-12
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 Name3 POSITION RECLINER BASIC ROSEWOOD 9153641231
Generic NameCHAIR AND TABLE, MEDICAL
Product CodeKMN
Date Received2015-01-12
Model NumberIH6074A/IH60
OperatorLAY USER/PATIENT
Device AvailabilityN
Device Age6 MO
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerGOODBABY
Manufacturer AddressCH


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2015-01-12

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