BEUDAMED
    FDA Adverse Event Death Summary report: N

    VENTURE DELUXE WHEELCHAIR

    MDR report key: 1202206 · Received October 14, 2008

    Report

    Report Number
    MW5008629
    Event Type
    Death
    Date Received
    October 14, 2008
    Date of Event
    October 4, 2008
    Report Date
    October 14, 2008
    Manufacturer
    TUFFCARE INC
    Product Code
    IOR
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    ME, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PT RANG BELL TO GET ASSISTANCE TO USE THE BATHROOM. PT & RN WENT INTO THE BATHROOM & THE TOILET WAS MALFUNCTIONING. THE RN WENT TO CALL MAINTENANCE DEPT. ON THE WAY BACK TO HELP THE PT WITH TOILETING, RN SAW PT ATTEMPT TO BACK UP HIS WHEELCHAIR. PT WAS EVIDENTLY TOO FORCEFUL WHEN TRYING TO BACK UP AND SWING WHEELCHAIR AROUND SINCE HE THEN TIPPED OVER BACKWARDS IN THE CHAIR, AND FELL OUT OF CHAIR ONTO THE FLOOR. PT HIT HEAD ON THE FLOOR. DATES OF USE: 2008. DIAGNOSIS OR REASON FOR USE: SWING BED PT REHAB FOR LEFT BELOW KNEE AMPUTATION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 VENTURE DELUXE WHEELCHAIR WHEELCHAIR IOR TUFFCARE INC 277BL

    Patients

    Seq Age Sex Outcome Treatment
    1 85 YR Death