FDA Adverse Event
Other
Summary report: N
GOLVO
MDR report key: 1885930
·
Received October 26, 2010
Report
- Report Number
- 8030916-2010-00020
- Event Type
- Other
- Date Received
- October 26, 2010
- Date of Event
- September 24, 2010
- Report Date
- September 27, 2010
- Manufacturer
- LIKO AB
- Product Code
- FSA
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MN, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
(B)(4). REPORT IS FILED DUE TO ALLEGED INJURY. CURRENT USER GUIDE COVERS PROPER TRANSFER METHODS AND USE. (B)(4). FACILITY STAFF TRIED TO RECREATE THE INCIDENT AND WERE UNABLE TO DO SO.
Description of Event or Problem · 1
DISTRIBUTOR REPORTED THAT A RESIDENT WAS BEING TRANSFERRED FROM BED TO WHEELCHAIR WHEN THE GOLVO TILTED OVER. THE RESIDENT HIT HEAD WITH SUPERFICIAL CUT TO BACK OF THE HEAD.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | GOLVO | NON-AC POWERED PATIENT LIFT | FSA | LIKO AB | GOLVO LOW BASE |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 81 YR |