FDA Adverse Event Other Summary report: N

GUARDIAN COMMODE

MDR report key: 1023753 · Received March 4, 2008

Report

Report Number
3006459587-2008-00004
Event Type
Other
Date Received
March 4, 2008
Date of Event
February 13, 2008
Report Date
March 3, 2008
Manufacturer
PROFIT COUNTRY ENTERPRISE LTD
Product Code
INB
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

AFTER REVIEWING THE DEVICE, THERE ARE NO EXTERNAL SIGNS THAT WOULD HAVE CAUSED THE DEVICE TO FAIL. IT APPEARS THE COMMODE WAS USED CORRECTLY. FROM THE DIRECTION OF THE BENT LEG, IT APPEARS THE USER HAD LEANED BACK AND TO HIS LEFT RESULTING IN MORE PRESSURE / WEIGHT BEING APPLIED TO THE ONE LEG. THE LEG BENT FROM THE INCREASED LOAD.

Description of Event or Problem · 1

A HOSPITAL REPORTED A USER OF A GUARDIAN COMMODE FELL AND HIT HIS HEAD AFTER THE LEFT BACK LEG BENT INWARD.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GUARDIAN COMMODE COMMODE INB PROFIT COUNTRY ENTERPRISE LTD 98202 0707

Patients

Seq Age Sex Outcome Treatment
1 UNK Other