BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    (P.V.C. SH) CARE PRODUCTS, INC.

    MDR report key: 225177 · Received May 25, 1999

    Report

    Report Number
    MW1016390
    Event Type
    Malfunction
    Date Received
    May 25, 1999
    Date of Event
    April 22, 1999
    Report Date
    May 20, 1999
    Manufacturer
    THE ANTHROS MEDICAL GROUP
    Product Code
    INM
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NY, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    RESIDENT SITTING IN SHOWER CHAIR WHEN SHOWER CHAIR BROKE, CAUSING RESIDENT TO FALL ON TO HER LEFT SIDE ON THE FLOOR. NO SERIOUS INJURY. CAPACITY OF CHAIR 300 LBS, RESIDENT ONLY 175 LBS. CHAIR SENT TO MAINTENANCE AND NOTED STRESS. FRACTURE IN PLASTIC PIPING. CHAIR SCRAPPED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 (P.V.C. SH) CARE PRODUCTS, INC. SHOWER CHAIR INM THE ANTHROS MEDICAL GROUP * *

    Patients

    Seq Age Sex Outcome Treatment
    1 63 YR Other