BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    NON AC-POWERED PATIENT LIFT

    MDR report key: 3171345 · Received June 14, 2013

    Report

    Report Number
    1525712-2013-04704
    Event Type
    Malfunction
    Date Received
    June 14, 2013
    Report Date
    May 20, 2013
    Manufacturer
    UNKNOWN
    Product Code
    FSA
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    UT, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4). THE PATIENT FALL OUT OF THE SLING AND ONTO THE FLOOR. NO MEDICAL INTERVENTION ALLEGED.

    Description of Event or Problem · 1

    PER THE PROVIDER THE STITCHING AT THE V POINT WHERE THEY MEET THE STITCHING ON ONE OF THE STRAPS CAME APART.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    271915 NON AC-POWERED PATIENT LIFT 880.5510 FSA UNKNOWN 9805

    Patients

    Seq Age Sex Outcome Treatment
    1 Other