BEUDAMED
    FDA Adverse Event Injury Summary report: N

    AMBICHAIR

    MDR report key: 18829 · Received January 5, 1995

    Report

    Report Number
    MW1004679
    Event Type
    Injury
    Date Received
    January 5, 1995
    Date of Event
    December 5, 1994
    Report Date
    December 7, 1994
    Manufacturer
    THE ANTHROS MEDICAL GROUP
    Product Code
    INM
    Report Source
    Voluntary report
    Reporter Location
    NJ, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    RESIDENT WAS AMBULATING IN THE CHAIR AT 10 PM AND SHE WAS FOUND LYING ON THE FLOOR AND HAD SUSTAINED A LACERATION TO THE BACK OF THE HEAD. AFTER SHE WAS TRANSFERED TO THE HOSP, THE NURSE NOTICED THE WHEEL OF THE CHAIR WAS BROKEN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 AMBICHAIR AMBULATION ASSISTIVE DEVICE INM THE ANTHROS MEDICAL GROUP

    Patients

    Seq Age Sex Outcome Treatment
    1 96 YR Hospitalization