BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HOVEROUND CORPORATION

    MDR report key: 1113186 · Received August 12, 2008

    Report

    Report Number
    1056601-2008-00020
    Event Type
    Injury
    Date Received
    August 12, 2008
    Date of Event
    January 8, 2008
    Report Date
    August 11, 2008
    Manufacturer
    HOVEROUND CORPORATION
    Product Code
    ITI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    NO MALFUNCTION OF MOTORIZED WHEELCHAIR SUSPECTED. THE END USER REPORTED THAT HER SPOUSE IMPROPERLY TRANSFERRED HER INTO THE MOTORIZED WHEELCHAIR'S SEAT WITH A HOYER LIFT AND SHE ALLEGEDLY SLID OUT OF SEAT WHILE OPERATING THE EQUIPMENT DOWN A MOTOR VEHICLE'S RAMP.

    Description of Event or Problem · 1

    END USER ALLEGES, AS A RESULT OF HER SPOUSE NOT PROPERLY SITUATING HER IN THE MOTORIZED WHEELCHAIR'S SEAT AFTER TRANSFERRING HER INTO THE MOTORIZED WHEELCHAIR WITH A HOYER LIFT, SHE SLID OFF OF THE SEAT WHILE EXITING A MOTOR VEHICLE ON A RAMP. ALLEGEDLY, FRACTURED BOTH ANKLES.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HOVEROUND CORPORATION MOTORIZED WHEELCHAIR ITI HOVEROUND CORPORATION MPV4

    Patients

    Seq Age Sex Outcome Treatment
    1 63 YR Hospitalization