BEUDAMED
    FDA Adverse Event Injury Summary report: N

    NON AC-POWERED PATIENT LIFT

    MDR report key: 3230700 · Received July 16, 2013

    Report

    Report Number
    3004493922-2013-01518
    Event Type
    Injury
    Date Received
    July 16, 2013
    Date of Event
    June 25, 2013
    Report Date
    June 26, 2013
    Manufacturer
    INVACARE SUZHOU
    Product Code
    FSA
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WI, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4). MALFUNCTION ALLEGED. THE PROVIDER STATED A RESIDENT ALLEGEDLY FELL TO THE GROUND AS THE SWIVEL ARM ON THE INVACARE LIFT CAME APART AND BROKE. THE RESIDENT ALLEGEDLY HAS A LEFT HIP CONTUSION BUT WAS NOT HOSPITALIZED. MEDICAL INTERVENTION PROVIDED BY FACILITY. THE LIFT WAS TAKEN OUT OF SERVICE.

    Description of Event or Problem · 1

    THE PROVIDER STATED A RESIDENT ALLEGEDLY FELL TO THE GROUND AS THE SWIVEL ARM ON THE INVACARE LIFT CAME APART AND BROKE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    329215 NON AC-POWERED PATIENT LIFT 880.5510 FSA INVACARE SUZHOU RPL450-2

    Patients

    Seq Age Sex Outcome Treatment
    1 Other