FDA Adverse Event
Injury
Summary report: N
GOLDEN PR120
MDR report key: 2310603
·
Received October 4, 2011
Report
- Report Number
- 2523955-2011-00001
- Event Type
- Injury
- Date Received
- October 4, 2011
- Date of Event
- June 19, 2011
- Report Date
- September 27, 2011
- Manufacturer
- GOLDEN TECHNOLOGIES, INC.
- Product Code
- INO
- PMA / PMN Number
- K880800
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
THE END USER AGREED THEY SLIPPED GETTING OUT OF THE CHAIR AND WANTS A COTTON NON-SKID FABRIC COVER ON HER CHAIR. END USER STATED THAT THERE IS NOTHING WRONG WITH THE LIFT CHAIR.
Description of Event or Problem · 1
END USERS CLAIMS THAT THEY SLID AND FELL OUT OF THE LIFT CHAIR TRYING TO GET OUT OF IT IN THE RAISED POSITION. HER HUSBAND TRIED TO CATCH HER AND SHE FELL ON THE FLOOR LANDING ON HER KNEE. SHE FRACTURED HER KNEE AND BROKE HER FEMUR AND TOE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | GOLDEN PR120 | LIFT CHAIR | INO | GOLDEN TECHNOLOGIES, INC. | PR120 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Hospitalization |