BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MAXI MOVE

    MDR report key: 3022522 · Received March 21, 2013

    Report

    Report Number
    9681684-2013-00016
    Event Type
    Injury
    Date Received
    March 21, 2013
    Date of Event
    February 18, 2013
    Report Date
    February 19, 2013
    Manufacturer
    ARJOHUNTLEIGH MAGOG INC
    Product Code
    FSA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IN, US
    Reporter Occupation
    NURSE

    Narratives

    Additional Manufacturer Narrative · 1

    THIS REPORT IS BEING FILED UNDER EXEMPTION (B)(4) BY THE MFR (B)(4). ON BEHALF OF THE IMPORTER (B)(6). THE DEVICE WAS INSPECTED ON-SITE BY A REP OF THE MFR'S SALES AND SERVICE UNIT SUBSIDIARY DIVISION, NOT A DIRECT EMPLOYEE OF THE MFR. ADDITIONAL INFO WILL BE PROVIDED UPON CONCLUSION OF THE MFR'S INVESTIGATION.

    Description of Event or Problem · 1

    THE PT WAS BEING TRANSFERRED FROM HIS BED TO HIS WHEELCHAIR. TWO CAREGIVERS WERE IN POSITION AND HELPING WITH THE TRANSFER. THE PT WAS BUMPING THE SLING CLIP IN A WAY THAT THE CLIP COULD DETACH FROM THE HANGER BAR LOCKING PIN. HE WAS SLIDING OUT OF THE SLING, FELL TO THE FLOOR AND BUMPED HIS HEAD.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    116918 MAXI MOVE MANUFACTURED FLOOR PASSIVE LIFT FSA ARJOHUNTLEIGH MAGOG INC KMCLUN

    Patients

    Seq Age Sex Outcome Treatment
    1 70 YR