BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    (NONE FOUND)

    MDR report key: 1951106 · Received December 29, 2010

    Report

    Report Number
    MW5018841
    Event Type
    Malfunction
    Date Received
    December 29, 2010
    Report Date
    December 28, 2010
    Manufacturer
    CLINTON INDUSTRIES
    Product Code
    KMN
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    WA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    THIS DEVICE IS A SAFETY BLOOD DRAW CHAIR, IN THAT AN ARM IS PROVIDED TO KEEP THE PT FROM FALLING FORWARD, IF PT PASSES OUT DURING BLOOD DRAW PROCESS. THE PROBLEM IS THE NARROW BASE OF THE CHAIR; IF ONE FALLS FORWARD, THE ENTIRE CHAIR GOES WITH THEM, ENDING UP ON TOP OF THEM AS THE FALL TO THE FLOOR. WE HAD TO ATTACH THE CHAIR TO THE WALL TO MAKE IT SAFE. THE MANUFACTURER AND SELLER BOTH IGNORED US WHEN WE REPORTED THE PROBLEM TO THEM SOME TIME AGO. THE SAME ITEM STILL APPEARS IN THEIR NEW CATALOG. (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 (NONE FOUND) EXTRA-TALL UPHOLSTERED BLOOD DRAW CHAIR KMN CLINTON INDUSTRIES NONE GIVEN NONE GIVEN

    Patients

    Seq Age Sex Outcome Treatment
    1