FDA Adverse Event Other Summary report: N

ENTERPRISE 9000+LIFTING POLE/ADJ STRAP & HANDLE

MDR report key: 2104989 · Received May 6, 2011

Report

Report Number
3003984900-2011-00014
Event Type
Other
Date Received
May 6, 2011
Date of Event
April 1, 2011
Report Date
April 8, 2011
Manufacturer
ARJOHUNTLEIGH
Product Code
FSA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

ADD'L INFO WILL BE PROVIDED PENDING THE CONCLUSION OF THE MFR'S INVESTIGATION.

Description of Event or Problem · 1

THE PT WAS PULLING DOWN ON THE LIFTING HANDLE TO REPOSITION HIMSELF IN BED, WHEN THE RETRACTABLE STRAP MECHANISM LET LOOSE UNEXPECTEDLY. THIS CAUSED THE STRAP TO FULLY EXTEND AND THE HANDLE TO HIT THE PT IN THE FACE. THE PT HAD BOTH HANDS ON THE HANDLE AND THE STRAP RELEASE BUTTON WAS NOT TOUCHED. THE PT SUFFERED A SHORT LASTING MINOR NOSEBLEED AND HAD NO VISIBLE FACIAL INJURY (LACERATION, ABRASION, CONTUSION, ETC).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENTERPRISE 9000+LIFTING POLE/ADJ STRAP & HANDLE ACCESSORIES - LIFTING & EQUIPMENT HANDLE FSA ARJOHUNTLEIGH ENT-ACC03

Patients

Seq Age Sex Outcome Treatment
1 Other