BEUDAMED
    FDA Adverse Event Death Summary report: N

    PORTABLE COMMODE

    MDR report key: 3269178 · Received August 2, 2013

    Report

    Report Number
    MW5031285
    Event Type
    Death
    Date Received
    August 2, 2013
    Date of Event
    June 24, 2013
    Report Date
    June 29, 2013
    Manufacturer
    GUARDIAN PRODUCT CO INC
    Product Code
    ILS
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MD, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    ON MONDAY, (B)(6) 2013, MY ELDERLY FATHER, DR (B)(6), WAS GETTING OUT OF BED AT HIS ASSISTED LIVING FACILITY. HE LEANED ON HIS BEDSIDE GUARDIAN COMMODE TO SUPPORT HIS WEIGHT, BUT THE GUARDIAN COMMODE FAILED TO SUPPORT HIS WEIGHT, AND ONE OF THE REAR LEGS RETRACTED ((B)(6)). AS A RESULT, MY FATHER FELL, SUFFERING A SKULL FRACTURE, A C1 LATERAL MASS FRACTURE IN HIS NECK, AND AN L1 LUMBAR COMPRESSION FRACTURE IN HIS LOWER BACK. FOUR DAYS LATER, ON FRIDAY, (B)(6), MY FATHER DIED OF THE INJURIES HE SUFFERED IN THE FALL. (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    363138 PORTABLE COMMODE COMMODE ILS GUARDIAN PRODUCT CO INC

    Patients

    Seq Age Sex Outcome Treatment
    1 84 YR Death