BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNKNOWN

    MDR report key: 3192574 · Received May 21, 2013

    Report

    Report Number
    3192574
    Event Type
    Injury
    Date Received
    May 21, 2013
    Date of Event
    March 5, 2013
    Report Date
    May 20, 2013
    Manufacturer
    UNK (RENTAL)
    Product Code
    FSA
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    ME, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    CNA WAS NOT FOLLOWING CARE PLAN OF TWO ASSIST WITH HOYER LIFT TRANSFER FOR THIS PT. THERE WAS NO EQUIPMENT MALFUNCTION AND THE CORRECT SLING WAS BEING USED. HOWEVER, DUE TO CNA ATTEMPTING HOYER TRANSFER BY HERSELF, PT DID FALL FROM THE HOYER AND FRACTURED RIGHT SHOULDER AND LEFT ARM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    225421 UNKNOWN HOYER LIFT FSA UNK (RENTAL) UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 76 YR Hospitalization