BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    AMBULIFT BSQ

    MDR report key: 361673 · Received November 19, 2001

    Report

    Report Number
    9617021-2001-00179
    Event Type
    Malfunction
    Date Received
    November 19, 2001
    Date of Event
    October 11, 2001
    Report Date
    October 17, 2001
    Manufacturer
    ARJO LTD.
    Product Code
    FSA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    UK
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    THE FACILITY REPORTS THE PATIENT WAS BEING TRANSFERRED TO ANOTHER LIFT WHEN THE AMBULIFT CHAIR BECAME DETACHED AND FELL TO THE FLOOR. NO INJURIES WERE NOTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    52291 AMBULIFT BSQ PATIENT LIFT FSA ARJO LTD. ABXXXX AB1402

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN