BEUDAMED
    FDA Adverse Event Death Summary report: N

    MAXILIFT

    MDR report key: 1041039 · Received May 9, 2008

    Report

    Report Number
    9617021-2008-00018
    Event Type
    Death
    Date Received
    May 9, 2008
    Date of Event
    February 9, 2008
    Report Date
    May 9, 2008
    Manufacturer
    ARJO MED AB LTD.
    Product Code
    FNG
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NE, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    THE FACILITY REPORTS THE RESIDENT WAS BEING TRANSFERRED FROM THE CHAIR TO HER BED WITH THE MECHANICAL LIFT. THE SUPPORT/HANGER BAR FELL OUT OF THE LIFT ARM (LIFT PIN SHEARED). THE RESIDENT DROPPED TO THE CHAIR AND SLID TO THE FLOOR. NO INJURIES WERE APPARENT AT THE TIME OF THE INCIDENT. HOWEVER, THE RESIDENT PASSED AWAY A FEW HOURS LATER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MAXILIFT PATIENT LIFT FNG ARJO MED AB LTD. KMBXXXX

    Patients

    Seq Age Sex Outcome Treatment
    1 99 YR Death