FDA Adverse Event Injury Summary report: N

MERRYWALKER

MDR report key: 1113 · Received August 18, 1992

Report

Report Number
1113
Event Type
Injury
Date Received
August 18, 1992
Date of Event
May 17, 1992
Report Date
May 20, 1992
Manufacturer
THE ANTHROS MEDICAL GROUP
Product Code
INP
Adverse Event
Yes
Report Source
User Facility report

Narratives

Description of Event or Problem · 1

UNWITNESSED FALL, RESIDENT WAS FOUND BY SINK IN ROOM STILL IN MERRYWALKER BUT TIPPED OVER. 5CM HEMATOMA ON HEAD WITH 2.5 CM CUT WHICH BLED PROFUSELY. COMPLAINED OF (L) ELBOW & (L) HIP PAIN. FOLLOW-UP X-RAYS OF ELBOW & HIP WERE NEGATIVE. RESIDENT HAD USED MERRYWALKER ON A DAILY BASIS & SEEMED TO ENJOY GETTING AROUND BETTER THAN MANUVERING WHEELCHAIR. SHE IS NOW BACK IN WHEELCHAIRINVALID DATA - REGARDING SINGLE USE LABELING OF DEVICE. PATIENT MEDICAL STATUS PRIOR TO EVENT: SATISFACTORY CONDITION. THERE WAS NOT MULTIPLE PATIENT INVOLVEMENT.INVALID DATA - ON DEVICE SERVICE/MAINTENANCE. NO DATA - REGARDING DATE LAST SERVICED. SERVICE PROVIDED BY: INVALID DATA. INVALID DATA - SERVICE RECORDS AVAILABILITY. NO IMMINENT HAZARD TO PUBLIC HEALTH CLAIMED. DEVICE USED AS LABELED/INTENDED.DEVICE WAS EVALUATED AFTER THE EVENT. METHOD OF EVALUATION: ACTUAL DEVICE INVOLVED IN INCIDENT WAS EVALUATED, VISUAL EXAMINATION. RESULTS OF EVALUATION: NONE OR UNKNOWN. CONCLUSION: NO FAILURE DETECTED AND PRODUCT WITHIN SPECIFICATION. CERTAINTY OF DEVICE AS CAUSE OF OR CONTRIBUTOR TO EVENT: INVALID DATA. CORRECTIVE ACTIONS: DEVICE TEMPORARILY REMOVED FROM SERVICE. THE DEVICE WAS NOT DESTROYED/DISPOSED OF.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MERRYWALKER INP THE ANTHROS MEDICAL GROUP NONE FOUND

Patients

Seq Age Sex Outcome Treatment
1 93 YR Required Intervention