BEUDAMED
    FDA Adverse Event Injury Summary report: N

    GOLVO

    MDR report key: 2110070 · Received May 20, 2011

    Report

    Report Number
    8030916-2011-00032
    Event Type
    Injury
    Date Received
    May 20, 2011
    Date of Event
    April 13, 2011
    Report Date
    April 13, 2011
    Manufacturer
    LIKO AB
    Product Code
    FSA
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    KY, US
    Reporter Occupation
    BIOMEDICAL ENGINEER

    Narratives

    Additional Manufacturer Narrative · 1

    LOCAL REP VISITED THE FACILITY AND LIFT WAS INSPECTED. GOLVO WAS FOUND TO BE FUNCTIONING PROPERLY AND WAS NOT DAMAGED. LIFT WAS RETURNED TO SERVICE AT THE FACILITY. AN INCIDENT REPORT WAS REQUESTED FROM THE FACILITY, BUT WAS NOT MADE AVAILABLE.

    Description of Event or Problem · 1

    INFO RECEIVED INDICATED THAT A PT WAS BEING LOWERED FROM THE LIFT AT ITS HIGHEST POSITION, INTO A RECLINED CHAIR. THE LIFT TIPPED OVER LANDING ON THE CAREGIVER'S SHOULDER. THE PT FELL ON TOP OF THE CHAIR, FRACTURING THREE RIBS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 GOLVO NON-AC POWERED PATIENT LIFT FSA LIKO AB GOLVO 7007ES

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention