FDA Adverse Event Injury Summary report: N

ELAN SRE-3050 PFR STAIRLIFT

MDR report key: 19213434 · Received April 29, 2024

Report

Report Number
MW5154444
Event Type
Injury
Date Received
April 29, 2024
Report Date
April 26, 2024
Manufacturer
BRUNO INDEPENDENT LIVING AIDS, INC.
Product Code
ILK
Adverse Event
Yes
Report Source
Voluntary report
Reporter Location
MN, US
Reporter Occupation
PATIENT FAMILY MEMBER OR FRIEND
Health Professional
*

Narratives

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT FELT A SHOCKING SENSATION WHEN THEY WERE SITTING IN A CHAIR THAT LIFTED THEM UP THE STAIRS AND THEN THEIR LEG WOULD BE BOTHERING THEM. AGENT REVIEWED THE STAIR LIFT POTENTIALLY COULD BE EMITTING EMI(ELECTROMAGNETIC INTERFERENCE) TO CAUSE THE ISSUES WITH THEIR SCS(SPINAL CORD STIMULATOR). CALLER STATES TODAY HE DISCOVERED WHILE CHECKING THE INTEGRITY OF THE SYSTEM THAT CONTACT 15 HAS IMPEDANCE ISSUE, NOTED SPECIFICALLY 0/15 SHOWS 20,150OHMS. ADDITIONAL INFORMATION WAS RECEIVED FROM THE MANUFACTURER REPRESENTATIVE (REP) REPORTING THAT THE CAUSE OF THE SHOCKING WAS NOT DETERMINED. IT WAS STATED THAT THEY DO NOT KNOW THAT THE PATIENT DOES NOT EXPERIENCE ANY ELECTRICAL RESPONSES WHEN THEY SIT IN THE CHAIRLIFT CHAIR, BUT THEY DO FEEL SOME SORT OF INTERFERENCE WHEN THEY OPERATE THE CHAIRLIFT. THE SHOCKING SENSATION WAS RESOLVED AS LONG AS THE PATIENT DOES NOT USE THE STAIRLIFT. THIS HAS BEEN OCCURRING FOR 4-5 MONTHS. THIS REPORT REFLECTS INFORMATION RECEIVED BY FDA IN THE FORM OF A NOTIFICATION PER 803.22 (B)(2).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
131663 ELAN SRE-3050 PFR STAIRLIFT TRANSPORT, PATIENT, POWERED ILK BRUNO INDEPENDENT LIVING AIDS, INC. BRU:SRE:3050PFR

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown