BEUDAMED
    FDA Adverse Event Death Summary report: N

    500 LB SMART LIFT WITH SCALE

    MDR report key: 19714986 · Received July 10, 2024

    Report

    Report Number
    2183887-2024-00003
    Event Type
    Death
    Date Received
    July 10, 2024
    Date of Event
    August 16, 2023
    Report Date
    June 28, 2024
    Manufacturer
    EZ WAY, INC
    Product Code
    FSA
    UDI-DI
    848914000057
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MN, US
    Reporter Occupation
    NURSE
    Health Professional
    Yes

    Narratives

    Additional Manufacturer Narrative · 0

    RESIDENT WAS IN ACTIVE DECLINE BEFORE THE INCIDENT OCCURED.

    Description of Event or Problem · 0

    2 CNAS WERE MOVING A RESIDENT FROM A TUB TO A WHEELCHAIR WITH A SLING AND SMART LIFT. THE CNAS HOOKED THE SLING UP TO THE HANGER BARS AND LIFTED THE RESIDENT. THE CNAS TURNED THE RESIDENT IN THE LIFT BY GUIDING THE LEGS. THE RESIDENT WAS MOVED 2-3 FEET TOWARDS THE WHEELCHAIR, AND ONE OF THE LOOPS BY THE LEGS CAME OFF THE HANGER BARS, AND THE RESIDENT FELL. THE RESIDENT HAD A LACERATION ON THE HEAD AND A FRACTURED HUMOROUS. THE RESIDENT WAS TAKEN TO THE ED (EMERGENCY DEPARTMENT) FOR STAPLES TO THE HEAD AND WAS TAKEN BACK TO THE HOSPICE DEPARTMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    352080 500 LB SMART LIFT WITH SCALE LIFT FSA EZ WAY, INC L500PS 848914000057

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Female Life Threatening| D