BEUDAMED
    FDA Adverse Event Death Summary report: N

    PAL FULL BODY LIFT

    MDR report key: 362799 · Received November 15, 2001

    Report

    Report Number
    2132280-2001-00006
    Event Type
    Death
    Date Received
    November 15, 2001
    Date of Event
    November 10, 2001
    Report Date
    November 15, 2001
    Manufacturer
    PAL SUNRISE MACHINE & TOOL INC.
    Product Code
    FSA
    Report Source
    Manufacturer report
    Reporter Location
    MN, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    TWO STAFF MEMBERS WERE TRANSFERRING RESIDENT WITH A MECHANICAL LIFT FROM A HORIZON WHEEL CHAIR TO A BED. THE RESIDENT HAD BEEN LIFTED OFF THE HORIZON WHEEL CHAIR AND STAFF MEMBERS WERE TURNING THE RESIDENT TO PREPARE TO PLACE RESIDENT ON THE BED. THE RESIDENT DURING THIS TIME WAS KICKING LEGS AND CAUSING THE SLING TO ROCK. THEN SOME HOW THE STRAP ON THE RIGHT SIDE OF THE RESIDENT'S HEAD CAME OFF AND THE RESIDENT FELL HITTING HEAD AND RIGHT SIDE OF BODY. THE RESIDENT WAS APPROXIMATELY 3 1/2 FEET OFF THE GROUND WHEN THE INCIDENT OCCURRED. THE RESIDENT WAS TAKEN TO THE HOSPITAL BY AMBULANCE ON THAT SAME DAY AND IT WAS DISCLOSED THAT RESIDENT HAD A RIGHT SCAPULAR FRACTURE AND BROKE THE FIFTH AND SIXTH RIBS ON THE RIGHT SIDE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    51979 PAL FULL BODY LIFT MECHANICAL LIFT FSA PAL SUNRISE MACHINE & TOOL INC. PC350RB-6 NI

    Patients

    Seq Age Sex Outcome Treatment
    1 93 YR Death