BEUDAMED
    FDA Adverse Event Injury Summary report: N

    EZLIFT

    MDR report key: 1803015 · Received August 10, 2010

    Report

    Report Number
    MW5017093
    Event Type
    Injury
    Date Received
    August 10, 2010
    Date of Event
    July 29, 2010
    Report Date
    August 3, 2010
    Manufacturer
    EZ WAY, INC.
    Product Code
    FNG
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MI, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    WHILE TRANSFERRING RESIDENT USING THE LIFT, LIFT TIPPED. POST-INSPECTION REVEALED THAT BOLT ON BASE (LEG) WAS SHEARED. RESIDENT SUFFERED AN ABRASION ABOVE THE LEFT EYEBROW. ALSO, A RAISED AREA ON FOREHEAD.

    Devices

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

    Patients

    Seq Age Sex Outcome Treatment
    1 66 YR Hospitalization