FOAM MATTRESS VINYL 9153633137 IES0080

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2015-10-14 for FOAM MATTRESS VINYL 9153633137 IES0080 manufactured by Invacare (ltd) Uk.

Event Text Entries

[28510546] Should additional information become available for the patient a supplemental record will be filed.
Patient Sequence No: 1, Text Type: N, H10


[28510547] Dealer is stating that the mattress has a sink hole in the middle.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3007582653-2015-00009
MDR Report Key5146816
Date Received2015-10-14
Date of Report2015-09-17
Date Mfgr Received2015-09-17
Date Added to Maude2015-10-14
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
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 Location3
Manufacturer ContactKEVIN GUYTON
Manufacturer StreetONE INVACARE WAY
Manufacturer CityELYRIA OH 44035
Manufacturer CountryUS
Manufacturer Postal44035
Manufacturer Phone8003336900
Manufacturer G1INVACARE (LTD) UK
Manufacturer StreetPENCOED TECHNOLOGY PARK PENCOED
Manufacturer CityBRIDGEND
Manufacturer CountryUK
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameFOAM MATTRESS VINYL 9153633137
Generic NameCUSHION, FLOTATION
Product CodeKIC
Date Received2015-10-14
Model NumberIES0080
OperatorLAY USER/PATIENT
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerINVACARE (LTD) UK
Manufacturer AddressPENCOED TECHNOLOGY PARK PENCOED BRIDGEND UK


Patients

Patient NumberTreatmentOutcomeDate
10 2015-10-14

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