BEUDAMED
    FDA Adverse Event Death Summary report: N

    WHEELCHAIR SAFETY BELT

    MDR report key: 12299 · Received February 1, 1994

    Report

    Report Number
    12299
    Event Type
    Death
    Date Received
    February 1, 1994
    Date of Event
    January 17, 1994
    Report Date
    January 28, 1994
    Manufacturer
    ALI MED
    Product Code
    IQB
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    MN, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    RESIDENT WAS SITTING IN WHEELCHAIR AT RNS DESK. SHE WAS SEEN TO LEAN FORWARD AND FELL OUT OF WHEELCHAIR, LANDING ON RIGHT SIDE ON FLOOR. SAFETY SEAT BELT HAD BEEN CLOSED ACCORDING TO NURSING ASSISTANTS CARING FOR RESIDENT. SEAT BELT WAS NOT CLOSED AFTER FALL. PT HAD SKIN TEAR BELOW RIGHT KNEE. SHE HIT HEAD AGAINST RNS DESK. NEURO CHECKS WERE DONE FOR 3 DAYS. PHYSICIAN NOTIFIED OF FALL AND POSSIBLE INJURY-PROTRUSION OF RIGHT KNEE AREA. NO IMMEDIATE INTERVENTION ORDERED. PHYSICIAN VISIT ON 1/19//94 AND X-RAY ORDERED. EXAM OF SAFETY BELT AFTER FALL REVEALED THAT ONLY MINIMAL PRESSURE ON RELEASE BUTTON WAS NEEDED TO RELEASE THE SAFETY BELT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 WHEELCHAIR SAFETY BELT IQB ALI MED

    Patients

    Seq Age Sex Outcome Treatment
    1 98 YR Not Applicable| D