inforMED
MalfunctionGCW

767 INTEGRATED DIAGNOSTIC WALL SYSTEM

Received Jul 8, 2014 · Event occurred Jun 9, 2014

Report 1316463-2014-00004 · MDR key 4063420

Device

Generic name

Wall Transformer

Manufacturer

Welch Allyn, Inc.

Model number

76792-M

Catalog number

76792-XXX

Product problems

  • Device Dislodged or Dislocated

Patient

Not reported

  • No Consequences Or Impact To Patient

Narrative

Description of Event or Problem

WELCH ALLYN RECEIVED AN INITIAL REPORT FROM A FACILITY WITH AN ALLEGATION THAT THE WALL TRANSFORMER SYSTEM, MOUNTED OVER THE BED, HAD BEEN KICKED UPWARD AT THE BASE DISLODGING IT FROM THE WALL MOUNT. THE DEVICE HIT THE PATIENT'S FATHER, BUT DID NOT INJURE HIM.

Additional Manufacturer Narrative

WELCH ALLYN IS REPORTING THIS EVENT IN AN ABUNDANCE OF CAUTION PENDING COMPLETION OF THE INVESTIGATION. A FOLLOW-UP REPORT WILL BE SUBMITTED WHEN THE EVALUATION IS COMPLETE.