BEUDAMED
    FDA Adverse Event Death Summary report: N

    MEDISTRAINT, BELT, WHEELCHAIR

    MDR report key: 368044 · Received December 24, 2001

    Report

    Report Number
    1417592-2001-00026
    Event Type
    Death
    Date Received
    December 24, 2001
    Date of Event
    July 25, 2001
    Report Date
    December 21, 2001
    Manufacturer
    MEDLINE INDUSTRIES, INC.
    Product Code
    FMQ
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    THE PATIENT WAS RESTRAINED IN A WHEELCHAIR BY A WHEELCHAIR BELT. REPORTEDLY AT 2:40 PM PT WAS FOUND WITH BUTTOCKS RESTING ON THE FOOTRESTS OF THE WHEELCHAIR. THE BELT WAS POSITIONED ACROSS PATIENT'S NECK, AND PATIENT EXPIRED AT APPROXIMATELY 3:00 PM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    58403 MEDISTRAINT, BELT, WHEELCHAIR WHEELCHAIR BELT FMQ MEDLINE INDUSTRIES, INC. MDT829110 *

    Patients

    Seq Age Sex Outcome Treatment
    1 91 YR Death