BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PRIDE MOBILITY PRODUCTS

    MDR report key: 3853684 · Received June 6, 2014

    Report

    Report Number
    2530130-2014-00041
    Event Type
    Injury
    Date Received
    June 6, 2014
    Date of Event
    April 11, 2014
    Report Date
    July 16, 2014
    Manufacturer
    PRIDE MOBILITY PRODUCTS
    Product Code
    INO
    PMA / PMN Number
    K070950
    Removal / Correction Number
    N/A
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    US
    Reporter Occupation
    PATIENT FAMILY MEMBER OR FRIEND

    Narratives

    Additional Manufacturer Narrative · 1

    FAILURE TO HEED OWNER'S MANUAL WARNING ABOUT UNINTENDED OPERATION OF THE LIFT CHAIR.

    Additional Manufacturer Narrative · 1

    THE DEVICE HAS NOT BEEN MADE AVAILABLE FOR EVALUATION AT THIS TIME. SHOULD FURTHER INFORMATION OR THE DEVICE BECOME AVAILABLE, A FOLLOW-UP REPORT WILL THEN BE ISSUED.

    Description of Event or Problem · 1

    CUSTOMER'S DAUGHTER ALLEGES HER FATHER FELL ASLEEP IN THE LIFT CHAIR AND SOMEHOW THE CONTROLLER WEDGED UNDER HIM AND HE INADVERTENTLY POWERED THE LIFT CHAIR TO STANDING POSITION AND HE FELL OVER IN THE LIFT CHAIR.

    Description of Event or Problem · 1

    CUSTOMER'S DAUGHTER ALLEGES HER FATHER FELL ASLEEP IN THE LIFT CHAIR AND SOMEHOW THE CONTROLLER WEDGED UNDER HIM AND HE INADVERTANTLY POWERED THE LIFT CHAIR TO STANDING POSITION AND HE FELL OVER IN THE LIFT CHAIR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    332847 PRIDE MOBILITY PRODUCTS ELECTRIC POSITIONING CHAIR INO PRIDE MOBILITY PRODUCTS LL575KD N/A

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization