BEUDAMED
    FDA Adverse Event Death Summary report: N

    MEDI-MAN

    MDR report key: 270316 · Received March 17, 2000

    Report

    Report Number
    270316
    Event Type
    Death
    Date Received
    March 17, 2000
    Date of Event
    March 7, 2000
    Report Date
    March 16, 2000
    Manufacturer
    MEDI-MAN REHAB PRODUCTS
    Product Code
    FNG
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    MN, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    RESIDENT WAS BEING TRANSFERRED FROM BED TO WHEELCHAIR WITH THE MEDI-MAN LIFT. THE SCREW HOLDING THE SPREADER BAR FAILED TO HOLD, RESULTING IN THE RESIDENT BEING DROPPED FROM THE MEDI-MAN LIFT. TWO CERTIFIED NURSING ASSISTANTS WERE IN ATTENDANCE. THE FALL RESULTED IN DISPLACED LEFT DISTAL CLAVICLE FRACTURE AND LEFT PALMELAR SCALP LACERATION. DEATH OCCURRED ON 03/10/2000.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDI-MAN ELECTRIC PATIENT LIFT FNG MEDI-MAN REHAB PRODUCTS 622000E NA

    Patients

    Seq Age Sex Outcome Treatment
    1 72 YR Death