MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer report with the FDA on 2020-02-03 for GENERIC 180 T565 LH US manufactured by Acorn Stairlifts, Inc..
| Report Number | 3003124453-2020-00003 |
| MDR Report Key | 9662578 |
| Report Source | CONSUMER |
| Date Received | 2020-02-03 |
| Date of Report | 2020-03-19 |
| Date of Event | 2019-12-08 |
| Date Mfgr Received | 2020-01-04 |
| Device Manufacturer Date | 2019-03-18 |
| Date Added to Maude | 2020-02-03 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MS. DORIAN PEARSON-SHAVER |
| Manufacturer Street | 7001 LAKE ELLENOR |
| Manufacturer City | ORLANDO, FL FL 32809 |
| Manufacturer Country | US |
| Manufacturer Postal | 32809 |
| Manufacturer Phone | 4076500216 |
| Manufacturer G1 | ACORN STAIRLIFTS, INC. |
| Manufacturer Street | 7001 LAKE ELLENOR DRIVE |
| Manufacturer City | ORLANDO, FL FL 32809 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 32809 |
| Single Use | 3 |
| Remedial Action | RP |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | GENERIC 180 T565 LH US |
| Generic Name | POWER STAIRWAY CHAIR LIFT |
| Product Code | PCD |
| Date Received | 2020-02-03 |
| Returned To Mfg | 2020-01-31 |
| Device Availability | R |
| Device Age | DA |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ACORN STAIRLIFTS, INC. |
| Manufacturer Address | 7001 LAKE ELLENOR DRIVE ORLANDO, FL FL 32809 US 32809 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Hospitalization | 2020-02-03 |