BEUDAMED
    FDA Adverse Event Injury Summary report: N

    EZ LIFT

    MDR report key: 1640225 · Received March 22, 2010

    Report

    Report Number
    2183887-2010-00001
    Event Type
    Injury
    Date Received
    March 22, 2010
    Report Date
    March 22, 2010
    Manufacturer
    EZ WAY, INC.
    Product Code
    FNG
    PMA / PMN Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MN, US
    Reporter Occupation
    NURSE

    Narratives

    Additional Manufacturer Narrative · 1

    THE RESIDENT'S CONDITION CREATED AN UNUSUAL EVENT, RESULTING IN THE INCIDENT.

    Description of Event or Problem · 1

    A RESIDENT FELL OUT THE SIDE OF A SLING WHILE BEING TRANSFERRED BY A CNA IN A LIFT FROM A WHEELCHAIR TO A BED. THE RESIDENT BROKE HER HIP, AND SUFFERED A LACERATION TO HER HEAD. THE LIFT WAS (B) (4), AND THE SLING SERIAL NUMBER WAS WORN OFF THE TAG. THE LIFT DID NOT MALFUNCTION AND THE SLING WAS INTACT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 EZ LIFT PATIENT LIFT FNG EZ WAY, INC. 798

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK Hospitalization