BEUDAMED
    FDA Adverse Event Other Summary report: N

    PAL LIFT

    MDR report key: 20223 · Received March 13, 1995

    Report

    Report Number
    MW1005407
    Event Type
    Other
    Date Received
    March 13, 1995
    Date of Event
    February 27, 1995
    Report Date
    February 27, 1995
    Manufacturer
    SUNRISE MACHINE AND TOOL, INC.
    Product Code
    FSA
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    ND, US
    Reporter Occupation
    NO INFORMATION

    Narratives

    Description of Event or Problem · 1

    TWO CERTIFIED NURSING ASSISTANTS WERE TRANSFERRING A RESIDENT FROM BED TO WHEELCHAIR WITH MECHANICAL LIFT. RESIDENT BECAME STIFF AND JERKED BACK, CAUSING CHAIN ON LIFT TO UNHOOK BY LEFT SHOULDER, CAUSING RESIDENT TO LAND ON FLOOR, HITTING HEAD. CORRECT PAD WAS USED AND PROPERLY HOOKED TO LIFT PRIOR TO TRANSFER OF RESIDENT. WHEELS OF LIFT UNLOCKED DUE TO TRANSFERRING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PAL LIFT MECHANICAL LIFT FSA SUNRISE MACHINE AND TOOL, INC. PL250R-1

    Patients

    Seq Age Sex Outcome Treatment
    1 89 YR Other