BEUDAMED
    FDA Adverse Event Death Summary report: N

    EZ STAND

    MDR report key: 3750428 · Received March 24, 2014

    Report

    Report Number
    3750428
    Event Type
    Death
    Date Received
    March 24, 2014
    Date of Event
    March 12, 2014
    Manufacturer
    EZ WAY, INC.
    Product Code
    FSA
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    MN, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    RESIDENT FELL FROM EZ LIFT WHILE BEING TRANSFERRED FROM HER BED TO HER WHEELCHAIR. SHE FELL ONTO THE FLOOR WHEN THE LEFT HALF OF THE SLING CAME OFF OF THE EZ LIFT. ACCIDENT INVESTIGATION NOTED THAT RUBBER STOP ON LEFT SIDE OF LIFT ARM WAS MISSING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    171569 EZ STAND NONE FSA EZ WAY, INC. 898

    Patients

    Seq Age Sex Outcome Treatment
    1 95 YR Death