BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    GOLVO 7007 LOWBASE

    MDR report key: 2850232 · Received November 5, 2012

    Report

    Report Number
    8030916-2012-00099
    Event Type
    Malfunction
    Date Received
    November 5, 2012
    Date of Event
    September 27, 2012
    Report Date
    October 10, 2012
    Manufacturer
    LIKO AB
    Product Code
    FSA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CO, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    THE DISTRIBUTOR FOUND THAT THE ACCOUNT ASSEMBLED THE LIFTS AND DID NOT INSTALL THE MAST CORRECTLY ONTO THE BASE. THE DISTRIBUTOR PROPERLY INSTALLED THE MAST TO REPAIR THE LIFT.

    Description of Event or Problem · 1

    THE COMPLAINT STATED THAT THE MAST SEPARATED FROM THE BASE WITH A PATIENT ON IT. AS THEY WERE LIFTING THE PATIENT THE MAST FELL FORWARD. THE NURSING STAFF WAS ABLE TO CATCH THE MAST BEFORE IT HIT THE PATIENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 GOLVO 7007 LOWBASE LIFT, PATIENT, NON-AC-POWERED FSA LIKO AB 2000061

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK