BEUDAMED
    FDA Adverse Event Death Summary report: Y

    EZ WAY

    MDR report key: 16502492 · Received March 8, 2023

    Report

    Report Number
    2183887-2023-00001
    Event Type
    Death
    Date Received
    March 8, 2023
    Date of Event
    January 24, 2023
    Report Date
    February 24, 2023
    Manufacturer
    EZ WAY, INC.
    Product Code
    FSA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SD, US
    Reporter Occupation
    003

    Narratives

    Description of Event or Problem · 0

    TWO SECTIONS OF CEILING LIFT TRACK SEPARATED FROM THE TRACK UNION MOUNTING BRACKET AS THE PATIENT WAS BEING LIFTED FROM A SHOWER CHAIR. PATIENT FELL TO THE FLOOR AND THE CEILING LIFT MOTOR HIT THE PATIENT IN THE HEAD.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1736330 EZ WAY CEILING LIFT FSA EZ WAY, INC. CL650 MT

    Patients

    Seq Age Sex Outcome Treatment
    1 Male Death