BEUDAMED
    FDA Adverse Event Other Summary report: N

    MEDICHAIR

    MDR report key: 207953 · Received January 29, 1999

    Report

    Report Number
    2182598-1999-00001
    Event Type
    Other
    Date Received
    January 29, 1999
    Date of Event
    December 26, 1998
    Manufacturer
    SUNRISE MEDICAL, INC. HOYER DIV.
    Product Code
    FZK
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NC, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT A MALE PT WAS IN THE CHAIR. THE HEAD OF THE CHAIR WAS POSITIONED APPROX LESS THAN NINETY DEGREE ANGLE. THE NURSE WAS TURNED AWAY AND THE PT SLID DOWN THE CHAIR, CAUSING THE CHAIR TO TIP FORWARD. THE PT FELL FORWARD AND HIT HIS HEAD ON THE FLOOR. HE REQUIRED SUTURES TO HIS FOREHEAD.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDICHAIR CHAIR FZK SUNRISE MEDICAL, INC. HOYER DIV. 020-0205 UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 48 YR Other