BEUDAMED
    FDA Adverse Event Injury Summary report: N

    RIFTON 18" ARM CHAIR

    MDR report key: 40836 · Received September 30, 1996

    Report

    Report Number
    1319061-1996-00001
    Event Type
    Injury
    Date Received
    September 30, 1996
    Date of Event
    September 4, 1996
    Report Date
    September 24, 1996
    Manufacturer
    RIFTON EQUIPMENT
    Product Code
    KMN
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    SOURCE TELLS MFR THAT ARM CHAIR TIPPED OVER WITH PT STRAPPED IN IT. THIS RESULTED IN A HEAD INJURY. TREATMENT WAS ADMINISTERED IN HOSPITAL. PT HAS SUBSEQUENTLY RECOVERED FULLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 RIFTON 18" ARM CHAIR 18 ARM CHAIR KMN RIFTON EQUIPMENT NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 7 YR Required Intervention