BEUDAMED
    FDA Adverse Event Death Summary report: N

    MAXI MOVE

    MDR report key: 10545482 · Received September 17, 2020

    Report

    Report Number
    1419652-2020-00047
    Event Type
    Death
    Date Received
    September 17, 2020
    Date of Event
    September 7, 2020
    Report Date
    October 14, 2020
    Manufacturer
    ARJOHUNTLEIGH MAGOG INC.
    Product Code
    FSA
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    CA
    Reporter Occupation
    501

    Narratives

    Additional Manufacturer Narrative · 0

    PLEASE NOTE THAT UNIQUE IDENTIFIER WAS ADDED IN SECTION D OF THIS REPORT.

    Description of Event or Problem · 0

    PLEASE NOTE THAT UNIQUE IDENTIFIER WAS ADDED IN SECTION D OF THIS REPORT.

    Description of Event or Problem · 1

    IT WAS REPORTED TO ARJO REPRESENTATIVE THAT THERE WAS INCIDENT INVOLVING ARJO MAXI MOVE PASSIVE FLOOR LIFT AND PASSIVE CLIP SLING. DURING TRANSFER FROM A TOILET TO A BED, THE LEFT LEG CLIP DETACHED FROM A SPREADER BAR ATTACHMENT POINT (LUG). THE PATIENT SLIPPED OUT OF THE SLING. AS THE CONSEQUENCE OF THE INCIDENT A RESIDENT SUSTAINED SKIN TEAR ON THE BACK OF A RIGHT KNEE. DUE TO PAIN IN THE RIGHT SHOULDER, THE PATIENT WAS SENT TO THE HOSPITAL TO CONDUCT AN X-RAY, WHICH SHOWED NO SIGNS OF INJURY. THE PATIENT RETURNED TO THE FACILITY EARLY IN THE MORNING THE NEXT DAY. ADDITIONALLY, ARJO WAS INFORMED THAT THE PATIENT PASSED AWAY THE NEXT DAY AFTER THE INCIDENT OCCURRED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1012381 MAXI MOVE LIFT, PATIENT, NON-AC-POWERED FSA ARJOHUNTLEIGH MAGOG INC. KMCSUN-D

    Patients

    Seq Age Sex Outcome Treatment
    1 90 YR Death