BEUDAMED
    FDA Adverse Event Other Summary report: N

    SHOWER CHAIR

    MDR report key: 36339 · Received August 29, 1996

    Report

    Report Number
    MW1009823
    Event Type
    Other
    Date Received
    August 29, 1996
    Date of Event
    August 15, 1996
    Report Date
    August 23, 1996
    Manufacturer
    THE ANTHROS MEDICAL GROUP
    Product Code
    INN
    Report Source
    Voluntary report
    Reporter Location
    WI, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    RESIDENT HAD BEEN PLACED IN SHOWER CHAIR. CNA WAS TRANSPORTING PT TO SHOWER ROOM WHEN WHEEL OF CHAIR ROLLED OVER DOOR ENTRY MAT. PVC CHAIR LEG SPLIT CAUSING RESIDENT TO PITCH FORWARD FROM CHAIR. CNA INJURED BACK IN SUCCESSFUL ATTEMPT TO CUSHION RESIDENT FALL. CHAIR WAS PURCHASED BECAUSE IT WAS ABLE TO SUSTAIN WEIGHT OF THIS RESIDENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SHOWER CHAIR SHOWER CHAIR INN THE ANTHROS MEDICAL GROUP C-550-XW-C4P *

    Patients

    Seq Age Sex Outcome Treatment
    1 87 YR Other