PATIENT ROOM WALL SAVER RECL 3500000730

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-06-30 for PATIENT ROOM WALL SAVER RECL 3500000730 manufactured by Stryker Medical-kalamazoo.

Event Text Entries

[79036842] It was reported that the ottoman will not support the weight of the patient's legs/feet. There was patient involvement, however no adverse consequence or clinically relevant delay in treatment was reported.
Patient Sequence No: 1, Text Type: D, B5


[91205083] A stryker field service representative reached out to the customer to schedule and evaluation for this device to confirm the alleged event. However, upon contact with the customer, the customer alleged that there was no component level defect with this unit and that the chair had since been returned to regular circulation so the inspection was unable to be performed. The customer further reported that no further assistance was needed at this time. Unit unavailable for evaluation
Patient Sequence No: 1, Text Type: N, H10


[91205084] It was reported that the ottoman will not support the weight of the patient's legs/feet. There was patient involvement, however no adverse consequence or clinically relevant delay in treatment was reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0001831750-2017-00285
MDR Report Key6681867
Date Received2017-06-30
Date of Report2017-09-12
Date of Event2017-06-05
Date Mfgr Received2017-06-05
Device Manufacturer Date2017-04-18
Date Added to Maude2017-06-30
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. CHANDA BURGHARD
Manufacturer Street3800 EAST CENTRE AVENUE
Manufacturer CityPORTAGE MI 49002
Manufacturer CountryUS
Manufacturer Postal49002
Manufacturer Phone2693292100
Manufacturer G1STRYKER MEDICAL-KALAMAZOO
Manufacturer Street3800 EAST CENTRE AVENUE
Manufacturer CityPORTAGE MI 49002
Manufacturer CountryUS
Manufacturer Postal Code49002
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NamePATIENT ROOM WALL SAVER RECL
Generic NameCHAIR, EXAMINATION AND TREATMENT
Product CodeFRK
Date Received2017-06-30
Catalog Number3500000730
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerSTRYKER MEDICAL-KALAMAZOO
Manufacturer Address3800 EAST CENTRE AVENUE PORTAGE MI 49002 US 49002


Patients

Patient NumberTreatmentOutcomeDate
10 2017-06-30

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