BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PRIDE MOBILITY PRODUCTS

    MDR report key: 2200738 · Received August 11, 2011

    Report

    Report Number
    2530130-2011-00032
    Event Type
    Injury
    Date Received
    August 11, 2011
    Date of Event
    July 7, 2011
    Report Date
    September 21, 2011
    Manufacturer
    PRIDE MOBILITY PRODUCTS
    Product Code
    INO
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    NO DESIGN, MANUFACTURING, OR OPERATIONAL SPECIFICATION COULD BE ATTRIBUTED TO THE REPORTED INCIDENT. (B)(4)

    Additional Manufacturer Narrative · 1

    DEVICE NOT AVAILABLE FOR EVALUATION. WILL SUBMIT A FOLLOW-UP INVESTIGATION REPORT SHOULD THE DEVICE BECOME AVAILABLE.

    Description of Event or Problem · 1

    THE CUSTOMER WAS ALLEGEDLY LAYING IN LIFT CHAIR WHEN HE WENT TO A SEATED POSITION THE CHAIR DROPPED 2-3 INCHES RESULTING IN INJURY.

    Description of Event or Problem · 1

    THE CUSTOMER WAS ALLEGEDLY LAYING IN LIFT CHAIR WHEN HE WENT TO A SEATED POSITION THE CHAIR DROPPED 2-3 INCHES RESULTING IN INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PRIDE MOBILITY PRODUCTS LIFT CHAIR INO PRIDE MOBILITY PRODUCTS GL358L

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization