BEUDAMED
    FDA Adverse Event Summary report: N

    MAXILIFT - MAXI PILLAR

    MDR report key: 20940 · Received March 1, 1995

    Report

    Report Number
    20940
    Date Received
    March 1, 1995
    Report Date
    February 14, 1995
    Manufacturer
    ARJO-CENTURY INC.
    Product Code
    FNG
    Report Source
    User Facility report

    Narratives

    Description of Event or Problem · 1

    MAXILIFT WAS BEING USED TO TRANSFER A PATIENT FROM HIS BED TO HIS CHAIR. AS THE TRANSFER WAS BEING COMPLETED, THE LIFT FRAME BROKE OFF THE SUPPORT ARM DROPPING THE PATIENT DOWN INTO THE CHAIR - NO INJURY.INVALID DATA - REGARDING SINGLE USE LABELING OF DEVICE. PATIENT MEDICAL STATUS PRIOR TO EVENT: INVALID DATA. INVALID DATA - REGARDING MULTIPLE PATIENT INVOLVEMENT.INVALID DATA - ON DEVICE SERVICE/MAINTENANCE. NO DATA - REGARDING DATE LAST SERVICED. SERVICE PROVIDED BY: INVALID DATA. INVALID DATA - SERVICE RECORDS AVAILABILITY.INVALID DATA - REGARDING WHETHER EVENT PRESENTS IMMINENT HAZARD. INVALID DATA - WHETHER DEVICE USED AS LABELED/INTENDED.INVALID DATA - REGARDING EVALUATION BY USER AFTER EVENT. METHOD OF EVALUATION: INVALID DATA. RESULTS OF EVALUATION: INVALID DATA. CONCLUSION: INVALID DATA. CERTAINTY OF DEVICE AS CAUSE OF OR CONTRIBUTOR TO EVENT: INVALID DATA. CORRECTIVE ACTIONS: NO DATA. INVALID DATA - ON DEVICE DESTROYED/DISPOSED OF STATUS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MAXILIFT - MAXI PILLAR FNG ARJO-CENTURY INC. 43012-012-0692

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK Invalid Data