BEUDAMED
    FDA Adverse Event Other Summary report: N

    MEDI-LIFT

    MDR report key: 3952084 · Received June 19, 2014

    Report

    Report Number
    1419652-2014-00160
    Event Type
    Other
    Date Received
    June 19, 2014
    Date of Event
    May 18, 2014
    Report Date
    May 20, 2014
    Manufacturer
    ARJOHUNTLEIGH MAGOG INC.
    Product Code
    FSA
    Report Source
    Distributor report
    Reporter Location
    CA
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED BY THE CUSTOMER: "REVIEWED THE INCIDENT INVOLVING THE LIFT AND IT TIPPED OVER WHEN THE RESIDENT WAS IN IT AND REMAINS LOCKED UP TILL REVIEWED. THE WEIGHT OF THE RESIDENT WAS SUPPORTED WITH THE WHEELCHAIR AND DIDN'T FALL. HOWEVER, DURING THE INCIDENT, THE WHEELCHAIR ALSO WENT BACKWARDS AND QUERY IF THE LIFT TIPPED OVER DUE TO THE WHEELCHAIR TIPPING BACKWARDS AND TOOK THE LIFT WITH THE RESIDENT". REF # MFR 9681684-2014-00042.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    360258 MEDI-LIFT FSA ARJOHUNTLEIGH MAGOG INC. 7000-PLUS

    Patients

    Seq Age Sex Outcome Treatment
    1 86 YR Other