BEUDAMED
    FDA Adverse Event Death Summary report: N

    EXCALIBER

    MDR report key: 372193 · Received January 17, 2002

    Report

    Report Number
    372193
    Event Type
    Death
    Date Received
    January 17, 2002
    Date of Event
    September 11, 2001
    Report Date
    September 11, 2001
    Manufacturer
    FERNO-WASHINGTON, INC.
    Product Code
    FPO
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    GA, US
    Reporter Occupation
    EMERGENCY MEDICAL TECHNICIAN

    Narratives

    Description of Event or Problem · 1

    PT TRANSFERRED FROM HOSPITAL TO NURSING FACILITY. DIAGNOSIS RENAL FAILURE. AT NURSING FACILITY, FOOT OF STRETCHER WHEELS PLACED ON SIDEWALK. WHEN LIFTING HEAD OF STRETCHER OVER CURB, PT SHIFTED THEIR WEIGHT TO THE LEFT CAUSING THE STRETCHER TO SHIFT TO THE LEFT AND TOPPLE. BOTH EMT'S TRIED TO PREVENT TOPPLE OF PT AND STRETCHER AND WHEN THEY REALIZED THEY WERE UNABLE TO DO SO, THEY MAINTAINED HOLD OF PT AND STRECTHER TO CONTROL FALL. WHEN PT WAS ON THE GROUND, ONE EMT SECURED C-SPINE AND THE OTHER EMT UNSTRAPPED THE PT FROM THE STRETCHER AND EVALUATED THE PT. PT COMPLAINED OF SOME PAIN IN THE LEFT RIB CAGE WHERE STRETCHER STRAPS CROSSED TORSO. PT WAS TRANSPORTED BY EMERGENCY MEDICAL SYSTEM TO THE EMERGENCY DEPARTMENT OF THE HOSPITAL IN THAT COMMUNITY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 EXCALIBER AMBULANCE FPO FERNO-WASHINGTON, INC. * *

    Patients

    Seq Age Sex Outcome Treatment
    1 57 YR Death