BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MEDICAL CHAIR & TABLE

    MDR report key: 1591237 · Received January 29, 2010

    Report

    Report Number
    1834066-2010-00001
    Event Type
    Injury
    Date Received
    January 29, 2010
    Report Date
    January 29, 2010
    Manufacturer
    CHAMPION MFG.
    Product Code
    KMN
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IN, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    MFR RECEIVED INFO THAT A PT DID NOT REALIZE THEY WERE STANDING ON THE STEP OF THE CHAIR INSTEAD OF THE FLOOR. USER ALLEGEDLY FELL AND BROKE THEIR HIP. NO HISTORY TO SUGGESTS A PRODUCT PROBLEM. NATURE OF COMPLAINT SUGGESTS A USER ERROR. MDR FILED BASED ON ALLEGED BROKEN HIP.

    Description of Event or Problem · 1

    THE CONSUMER STOOD ON THE PULL OUT STEP AND ALLEGEDLY FELL AND BROKE THEIR HIP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDICAL CHAIR & TABLE 880.6140 KMN CHAMPION MFG.

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention