BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MAXI 500

    MDR report key: 3080735 · Received April 11, 2013

    Report

    Report Number
    1419652-2013-00092
    Event Type
    Injury
    Date Received
    April 11, 2013
    Date of Event
    March 19, 2013
    Report Date
    March 19, 2013
    Manufacturer
    ARJOHUNTLEIGH MAGOG INC
    Product Code
    FSA
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    VA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    CAREGIVER ASSISTED THE RESIDENT TO BE TRANSFERRED FROM WHEELCHAIR TO HER BED. WHEN CAREGIVER RAISED THE RESIDENT FROM WHEELCHAIR, SHE NOTICED THAT THE WHEELCHAIR RAISED AS WELL. THE CAREGIVER PLACED A HAND ON THE LIFTING ARM HANDLE AND PUSHED DOWN ON THE WHEELCHAIR WITH HER OTHER HAND. AS THE WHEELCHAIR WENT DOWN DUE TO CAREGIVER PUSHING IT DOWN, THE RESIDENT'S WEIGHT SHIFTED FORWARD, TOWARDS THE LOWER BAR OF LIFTING ARM. THIS CAUSED THE SLING AND/OR THE BAR TO PRESS TIGHT AGAINST HER GROIN AREA, CAUSING AN INJURY. PLEASE REF MFR #9681684-2013-00033.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    156380 MAXI 500 MANUFACTURED FLOOR PASSIVE LIFT FSA ARJOHUNTLEIGH MAGOG INC KM560181

    Patients

    Seq Age Sex Outcome Treatment
    1 82 YR Hospitalization