FDA Adverse Event Injury Summary report: N

DRIVE DEVILBISS HEALTHCARE PATIENT LIFT- ELECTRIC

MDR report key: 24818944 · Received April 8, 2026

Report

Report Number: 2438477-2026-00019
Event Type: Injury
Date Received: April 8, 2026
Date of Event: March 14, 2026
Report Date: April 9, 2026
Manufacturer: APEX HEALTHCARE MFG. INC.
Product Code: FSA
UDI-DI: 00822383103709
Adverse Event: Yes
Product Problem: Yes
Report Source: Distributor report
Reporter Location: NC, US
Reporter Occupation: 003

Narratives

Additional Manufacturer Narrative · 0

(B)(6) INCORRECTLY REPORTED THE MANUFACTURER AS SHENYANG HENYI ENTERPRISE CO., LTD, PUMP AND VALVE INDUSTRIAL PARK, NO.5 PANWU ROAD, YANGSHIGANG TOWN, SHENYANG 110200, CHN. THE CORRECT MANUFACTURER IS APEX HEALTHCARE MFG. INC., NO. 6 INDUSTRIAL 2ND ROAD, TOU CHIAO INDUSTRIAL PARK, MIN HSIUNG SHIANG, CHIA YI HSIEN, TW. SECTIONS D3, F 11,13 AND 14 WERE UPDATED TO REFLECT THE CORRECT INFORMATION.

Description of Event or Problem · 0

(B)(4) WAS NOTIFIED OF AN INCIDENT INVOLVING A PATIENT LIFT BY THE PROVIDER WHO REPORTED THAT THE END USER WAS BEING LIFTED TO THE BEDSIDE COMMODE WHEN THE BOLT FROM THE LIFT DISLODGED, CAUSING THE END USER TO FALL. AS A RESULT OF THE FALL, THE END USER SUSTAINED A HIP FRACTURE IN TWO LOCATIONS AND WAS HOSPITALIZED FOR SEVERAL DAYS. THE PROVIDER FURTHER REPORTED THAT ON (B)(6) 2026, THEY WERE INFORMED THAT THE END USER HAD PASSED AWAY. AT THIS TIME, IT IS UNKNOWN WHETHER THE INJURIES SUSTAINED DURING THE INCIDENT CAUSED OR CONTRIBUTED TO THE END USER'S DEATH. AS PART OF ITS COMPLAINT REVIEW AND EVALUATION PROCESS, (B)(4) WILL ALSO NOTIFY THE MANUFACTURER OF THE PRODUCT ABOUT THIS COMPLAINT.

Devices

Seq	Brand	Generic	Product Code	Manufacturer	Model	Lot	UDI-DI
188574	DRIVE DEVILBISS HEALTHCARE PATIENT LIFT- ELECTRIC	LIFT, PATIENT, NON-AC-POWERED	FSA	APEX HEALTHCARE MFG. INC.	13240		00822383103709

Patients

Seq	Age	Sex	Outcome	Treatment
1