BEUDAMED
    FDA Adverse Event Other Summary report: N

    ARJO

    MDR report key: 317985 · Received February 26, 2001

    Report

    Report Number
    317985
    Event Type
    Other
    Date Received
    February 26, 2001
    Date of Event
    January 29, 2001
    Report Date
    February 23, 2001
    Manufacturer
    ARJO INC
    Product Code
    FSA
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    ARJO LIFT TIPPED OVER RESIDENT AND EMPLOYEE INJURED. CNA WAS TRANSFERRING RESIDENT FROM SHOWER GURNEY USING THE LIFT. CNA WAS PULLING PT BACK WHEN HEARD A POPPING SOUND. THE LIFT THEN STARTED TO TIP OVER. CNA TRIED TO STOP IT FROM FALLING, AND TRIED TO LOWER RESIDENT TO FLOOR BUT ENTIRE UNIT RESIDENT AND CNA ALL FELL TO THE FLOOR. MINOR INJURIES. BACK WHEEL SHATTERED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    7652 ARJO MAXIMOVER LIFT FSA ARJO INC MAXIMOVER NA

    Patients

    Seq Age Sex Outcome Treatment
    1 55 YR Other SPIDER LIFT ARM AND X-LG SLING.