FDA Adverse Event Death Summary report: N

EZ LIFT/NORAM SLING

MDR report key: 1416083 · Received July 15, 2009

Report

Report Number
2183887-2009-00001
Event Type
Death
Date Received
July 15, 2009
Date of Event
June 20, 2009
Report Date
July 15, 2009
Manufacturer
EZ WAY, INC.
Product Code
FNG
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EZ WAY CONTACTED THE FACILITY AND WAS TOLD THE INCIDENT WAS NOT CAUSED BY ANY MALFUNCTION OF THE LIFT, BUT WAS CAUSED BY USER ERROR. AN EZ WAY SLING WAS NOT USED IN THE TRANSFER.

Description of Event or Problem · 1

DURING A TRANSFER WITH AN EZ LIFT AND A NORAM SLING, A RESIDENT FELL BACK OUT OF THE SLING, HITTING HIS HEAD ON THE FLOOR. THE RESIDENT WAS TAKEN TO THE HOSPITAL AND LATER EXPIRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 EZ LIFT/NORAM SLING LIFT/SLING FNG EZ WAY, INC. 798-LIFT 100-SLING NA

Patients

Seq Age Sex Outcome Treatment
1 49 YR Death| H