BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UMP CHAIR SENTRY

    MDR report key: 3131165 · Received July 18, 2008

    Report

    Report Number
    3131165
    Event Type
    Injury
    Date Received
    July 18, 2008
    Date of Event
    April 30, 2008
    Report Date
    May 8, 2008
    Manufacturer
    STANLEY - SENIOR TECHNOLOGIES
    Product Code
    KMI
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    MN, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    RESIDENT ADMITTED TO FACILITY (B)(6) 2008 AT 1330. A PAD ALARM WAS PLACED IN WHEELCHAIR AND ON BED AT 1630 AFTER A FALL WHEN RESIDENT TRIED TO GET OUT OF WHEELCHAIR. NO INJURIES INCURRED. AT 10:45 PM RESIDENT AGAIN TRIED TO GET OUT OF WHEELCHAIR IN HER ROOM. ALARM WAS IN PLACE AND ON IN CHAIR. ALARM DID NOT SOUND. FALL RESULTED IN A FRACTURED HIP. ALARM DID NOT SOUND. FALL RESULTED IN A FRACTURED HIP. RESIDENT TRANSPORTED VIA AMBULANCE TO HOSPITAL. ((B)(6)). MFR - 1929691-2008-00002.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 UMP CHAIR SENTRY CHAIR SENTRY KMI STANLEY - SENIOR TECHNOLOGIES 91610 C-1007

    Patients

    Seq Age Sex Outcome Treatment
    1 84 YR Other