BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MAXI MOVE

    MDR report key: 2223479 · Received June 30, 2011

    Report

    Report Number
    9681684-2011-00051
    Event Type
    Malfunction
    Date Received
    June 30, 2011
    Date of Event
    May 31, 2011
    Report Date
    June 1, 2011
    Manufacturer
    BHM MEDICAL INC.
    Product Code
    FSA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    ADDITIONAL INFO WILL BE PROVIDED FOLLOWING THE CONCLUSION OF THE MANUFACTURER'S INVESTIGATION.

    Description of Event or Problem · 1

    THE PT WAS BEING LIFTED FROM A WHEELCHAIR, JUST SLIGHTLY ABOVE THE CHAIR, THEN MOVED AWAY FROM THE CHAIR. AT THIS POINT, THE CARETAKER USED THE TILT OF THE SPREADER BAR AND THE RIGHT LEG SLING CLIP DETACHED. THE PT FELL TO THE FLOOR AND WAS THEN TAKEN TO THE HOSPITAL TO BE CHECKED FOR INJURIES, BUT NO ADDITIONAL DETAILS WERE RELEASED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MAXI MOVE MANUFACTURED FLOOR PASSIVE LIFT FSA BHM MEDICAL INC. KMCLUN-D

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization| O