BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MAXI MOVE

    MDR report key: 3234037 · Received July 11, 2013

    Report

    Report Number
    1419652-2013-00190
    Event Type
    Malfunction
    Date Received
    July 11, 2013
    Date of Event
    June 15, 2013
    Report Date
    June 27, 2013
    Manufacturer
    ARJOHUNTLEIGH MAGOG INC.
    Product Code
    FSA
    Product Problem
    Yes
    Report Source
    Distributor report
    Reporter Location
    BE
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT WAS IN WHEEL CHAIR. NURSE HAD ATTACHED THE SLING TO MAXIMOVE PT LIFTER. SHOULDER CLIPS HAVE DETACHED WHILE PT IS BEING LIFTED. ONLY THE LEGS WERE LIFTED, RESULTING IN BACKWARD TILTING OF WHEELCHAIR AND PT, WHICH BOTH FELL ON THE GROUND. NO INJURY WAS REPORTED. REF #9681684-2013-00061.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    319971 MAXI MOVE FSA ARJOHUNTLEIGH MAGOG INC. KMCSXE-D

    Patients

    Seq Age Sex Outcome Treatment
    1