BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    NON AC-POWERED PATIENT LIFT

    MDR report key: 3944398 · Received July 18, 2014

    Report

    Report Number
    1525712-2014-03792
    Event Type
    Malfunction
    Date Received
    July 18, 2014
    Date of Event
    April 3, 2013
    Report Date
    June 10, 2014
    Manufacturer
    UNKNOWN
    Product Code
    FSA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    PATIENT FAMILY MEMBER OR FRIEND

    Narratives

    Description of Event or Problem · 1

    CUSTOMER ALLEGED THAT HER SON FELL OUT OF THE LIFT WHILE AT DAY CARE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    421394 NON AC-POWERED PATIENT LIFT 880.5510 FSA UNKNOWN 9805P

    Patients

    Seq Age Sex Outcome Treatment
    1 37 Other