MAUDE MDR 611

MDR report key
611
Report number
611
Event key
0
Event type
3
Date of event
1992-05-02
Date received
1992-05-25
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
0
Initial report to FDA
0
Event location
3

Manufacturer Contact#

Report source
U
Manufacturer link flag
N

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1BED, WITH SIDE RAILLUMEX, INC.FNK*Y

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
11992-05-2501. R

Event Narratives#

D

Patient 1

RESIDENT WAS FOUND LYING ON RIGHT SIDE WITH (R) FOOT AND LEG EXTENDED THROUGH SIDE RAIL. WHEN REPOSITION (R) LEG AND FOOT ABDUCTED AND ROTATED. UPPER (R) EXTREMITY EDEMATOUS, TOES CYANOTIC. X-RAY REVEALED FX. (R) HIPINVALID DATA - REGARDING SINGLE USE LABELING OF DEVICE. PATIENT MEDICAL STATUS PRIOR TO EVENT: FAIR CONDITION. THERE WAS NOT MULTIPLE PATIENT INVOLVEMENT.INVALID DATA - ON DEVICE SERVICE/MAINTENANCE. NO DATA - REGARDING DATE LAST SERVICED. SERVICE PROVIDED BY: INVALID DATA. INVALID DATA - SERVICE RECORDS AVAILABILITY. NO IMMINENT HAZARD TO PUBLIC HEALTH CLAIMED. DEVICE USED AS LABELED/INTENDED.DEVICE WAS EVALUATED AFTER THE EVENT. METHOD OF EVALUATION: ACTUAL DEVICE INVOLVED IN INCIDENT WAS EVALUATED, PERFORMANCE TESTS PERFORMED, VISUAL EXAMINATION. RESULTS OF EVALUATION: NONE OR UNKNOWN. CONCLUSION: THERE WAS NO DEVICE FAILURE. CERTAINTY OF DEVICE AS CAUSE OF OR CONTRIBUTOR TO EVENT: INVALID DATA. CORRECTIVE ACTIONS: NONE OR UNKNOWN. INVALID DATA - ON DEVICE DESTROYED/DISPOSED OF STATUS.