FDA Adverse Event
Injury
Summary report: N
MAXIMOVE
MDR report key: 1368907
·
Received April 22, 2009
Report
- Report Number
- 9611530-2009-00028
- Event Type
- Injury
- Date Received
- April 22, 2009
- Date of Event
- April 6, 2009
- Report Date
- April 21, 2009
- Manufacturer
- ARJO HOSPITAL EQUIPMENT AB
- Product Code
- FNG
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IL, US
Narratives
Description of Event or Problem · 1
THE FACILITY INDICATED TWO CAREGIVERS WERE CONDUCTING A TRANSFER BACK TO THE BED WHEN THE RIGHT SHOULDER CLIP SNAPPED. THE PATIENT'S LEFT LEG RAISED AND AS HE ROLLED TO HIS RIGHT, THE LEFT SHOULDER CLIP BROKE. THE PATIENT FELL TO THE FLOOR. IT WAS NOTED THAT THE SLING'S HEAD SUPPORTS WERE MISSING. THE PATIENT WAS TAKEN TO THE EMERGENCY ROOM AND WAS DIAGNOSED AS HAVING A CONCUSSION. TREATMENT IS UNKNOWN.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | MAXIMOVE | PATIENT LIFT | FNG | ARJO HOSPITAL EQUIPMENT AB | KMBB4XXXXX |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 76 YR | Hospitalization |