FDA Adverse Event Injury Summary report: N

PRIDE MOBILITY PRODUCTS

MDR report key: 3241004 · Received July 22, 2013

Report

Report Number
2530130-2013-00053
Event Type
Injury
Date Received
July 22, 2013
Date of Event
July 12, 2013
Report Date
May 12, 2014
Manufacturer
PRIDE MOBILITY PRODUCTS
Product Code
INO
PMA / PMN Number
K070950
Removal / Correction Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE ALLEGED EVENT COULD NOT BE DUPLICATED THROUGH LOADED CYCLICAL TESTING.

Additional Manufacturer Narrative · 1

THE DEVICE IS NOT AVAILABLE FOR EVALUATION AT THIS TIME. SHOULD FURTHER INFORMATION OR THE DEVICE BECOME AVAILABLE, A FOLLOW-UP REPORT WILL THEN BE ISSUED.

Description of Event or Problem · 1

CUSTOMER WAS IN HER LIFT CHAIR RECLINING WHEN CHAIR BECAME STUCK. CUSTOMER TRIED TO GET OUT OF LIFT CHAIR WHEN SHE FELL OUT ON LEFT SIDE.

Description of Event or Problem · 1

CUSTOMER WAS IN HER LIFT CHAIR RECLINING WHEN CHAIR BECAME STUCK. CUSTOMER TRIED TO GET OUT OF LIFT CHAIR WHEN SHE FELL OUT ON LEFT SIDE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
340635 PRIDE MOBILITY PRODUCTS ELECTRIC POSITIONING CHAIR INO PRIDE MOBILITY PRODUCTS LC200 N/A

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization