FOAM LIMB HOLDER 2532

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a user facility report with the FDA on 2019-04-02 for FOAM LIMB HOLDER 2532 manufactured by Posey Products Llc.

Event Text Entries

[140654823] Evaluation results: evaluation of the returned device found the male buckle component at the bed connecting strap, on a single returned limb holder, was installed backward causing the bed connecting strap to slip when pulled. All buckles were compared to the product drawing and product sample. The male buckle installed incorrectly is a known issue related to documentation guiding the manufacturing process. The issue has been addressed internally via corrective action. Samples taken from multiple lots, at multiple facilities, found no other instances of incorrectly installed male buckles. All complaints are trended and reviewed by management on a monthly basis. As part of this monthly review, any excursion above the control limits for this failure mode will be assessed, documented and acted upon as warrant. Manufacturer reference file# (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[140654824] Customer reported that the wrist restraint does not restrain the patient and that they recently had a patient self-extubate. The customer stated that it appears to be that the clip on the unit was installed backwards. The date the issue was discovered is unknown.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2020362-2019-00064
MDR Report Key8474643
Report SourceUSER FACILITY
Date Received2019-04-02
Date of Report2019-03-05
Date Mfgr Received2019-03-05
Device Manufacturer Date2019-01-21
Date Added to Maude2019-04-02
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 ContactWILLIAM HINCY
Manufacturer StreetPOSEY PRODUCTS LLC 5635 PECK ROAD
Manufacturer CityARCADIA CA 91006
Manufacturer CountryUS
Manufacturer Postal91006
Manufacturer Phone6264433143
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameFOAM LIMB HOLDER
Generic NameRESTRAINT, PROTECTIVE
Product CodeFMQ
Date Received2019-04-02
Model Number2532
Catalog Number2532
Lot Number9021T147
Device AvailabilityY
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerPOSEY PRODUCTS LLC
Manufacturer Address5635 PECK RD ARCADIA CA 91006 US 91006


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2019-04-02

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