MAUDE MDR 8592666

MDR report key
8592666
Report number
1031452-2019-00011
Event key
0
Event type
3
Date received
2019-05-08
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MR. JASON FIEST
Address
ONE INVACARE WAY ELYRIA OH 44035 US
Phone
800-800-8003
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1IVC BARIATRIC BED 9153641598BARIATRIC BEDINVACARE FLORIDAOSINA:BAR600IVCBAR600IVCY N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-05-080

Event Narratives#

N

Patient 1

THE HEAD MOTOR ASSEMBLY, AND THE BARIATRIC FOOT SECTION WERE RETURNED TO INVACARE. THE COMPLAINT WAS CONFIRMED DURING AN EVALUATION. IT WAS DETERMINED THAT THE 6-FUNCTION CONTROL BOX EMITTED SMOKE AND PRODUCED SPARKS WHEN THE HEAD DOWN FUNCTION OPERATED. BASED ON THE LOCATION OF WHERE THE SPARKS AND SMOKE WERE PRODUCED AND AFTER REVIEWING THE ENGINEERING DRAWING FOR THE 6-FUNCTION PCB, IT WAS DETERMINED THAT THE CAUSE THE OF THE FAILURE WAS A DIRECT SHORT TO CAPACITOR C1 OF THE 6-FUNCTION CONTROL BOX. IT WAS DETERMINED THAT THE FAILURE WAS CONTAINED TO THE 6-FUNCTION CONTROL BOX, AND THERE WAS NO MALFUNCTION OR DEFECT TO THE HEAD MOTOR. A REPLACEMENT BAR5490IVC FOOT SECTION, WAS SENT TO THE DEALER FOR SERVICING OF THE BED, THE CONTROL BOX DATE CODE, JULY 13, 2016, FALLS OUTSIDE THE SCOPE OF RECALLS Z-2399/2402-2016 AND Z-1182/1185-2017. HOWEVER, THE RETURNED CONTROL BOX WAS MANUFACTURED PRIOR TO A DESIGN CHANGE TO IMPLEMENT A NEW CAPACITOR, ICO-157061, WHICH WAS IMPLEMENTED ON FEBRUARY 10, 2017. SINCE LAUNCH OF THIS DESIGN CHANGE, THERE HAVE BEEN NO FAILURES. SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL RECORD WILL BE FILED.

D

Patient 1

THE END USER ALLEGED THAT THEY SMELLED A BURNING SMELL AND SAW SMOKE COMING FROM THE FOOT SECTION OF THE BAR600IVC BED. THERE WERE NO INJURIES ALLEGED.