BEUDAMED
    FDA Adverse Event Death Summary report: N

    EZ CEILING LIFT AND TRACK

    MDR report key: 16363050 · Received February 10, 2023

    Report

    Report Number
    MW5114865
    Event Type
    Death
    Date Received
    February 10, 2023
    Date of Event
    January 24, 2023
    Report Date
    February 8, 2023
    Manufacturer
    EZ WAY INC.
    Product Code
    FSA
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NE, US
    Reporter Occupation
    501
    Health Professional
    Yes

    Narratives

    Description of Event or Problem · 0

    EZ WAY CEILING LIFT FAILED WHEN ENGAGED TO LIFT THE RESIDENT OFF OF A SHOWER CHAIR. WHEN ENGAGED, THE EZ WAY CEILING LIFT SEPARATED AT THE UNION OF THE TRACK CAUSING THE MOTOR TO DISENGAGE FROM THE TRACK. RESIDENT FELL TO THE FLOOR AND WAS STRUCK IN THE HEAD BY THE FALLING MOTOR, RESIDENT SUSTAINED A SUBARACHNOID BLEED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    2223883 EZ CEILING LIFT AND TRACK LIFT, PATIENT, NON-AC-POWERED FSA EZ WAY INC. CL650 MT

    Patients

    Seq Age Sex Outcome Treatment
    1 87 YR Male Death