BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    AMBULIFT BSQ

    MDR report key: 352559 · Received September 21, 2001

    Report

    Report Number
    9617021-2001-00133
    Event Type
    Malfunction
    Date Received
    September 21, 2001
    Date of Event
    June 29, 2001
    Report Date
    August 13, 2001
    Manufacturer
    ARJO, LTD.
    Product Code
    FSA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NL
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    THE FACILITY REPORTS AFTER WASHING THE RESIDENT THE NURSE HAD TO GO OUT OF THE BATH. THE UNDERCARRIAGE WAS PLACED UNDER THE LIFT AND THE RESIDENT FELL. THE DEVICE WAS FOUND TO BE OKAY AFTER EXAMINATION AND NO INJURIES WERE SUSTAINED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    43202 AMBULIFT BSQ PATIENT LIFT FSA ARJO, LTD. ABXXXX NA

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other