BEUDAMED
    FDA Adverse Event Injury Summary report: N

    EZ WAY

    MDR report key: 10157767 · Received June 15, 2020

    Report

    Report Number
    MW5095001
    Event Type
    Injury
    Date Received
    June 15, 2020
    Date of Event
    May 6, 2020
    Report Date
    June 11, 2020
    Manufacturer
    EZ WAY, INC.
    Product Code
    FSA
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    SD, US
    Reporter Occupation
    003

    Narratives

    Description of Event or Problem · 1

    AN EMPLOYEE WAS TRANSFERRING A RESIDENT USING AN EZ WAY SIT TO STAND PATIENT LIFT. WHILE TRANSFERRING THE ACTUATOR ON THE LIFT BROKE CAUSING THE RESIDENT TO FALL TO FLOOR WHERE HE SUSTAINED A NECK FRACTURE. FDA SAFETY REPORT ID# (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    616645 EZ WAY LIFT, PATIENT, NON-AC-POWERED FSA EZ WAY, INC. 898

    Patients

    Seq Age Sex Outcome Treatment
    1 88 YR Hospitalization