BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    NON AC-POWERED PATIENT LIFT

    MDR report key: 4121868 · Received September 26, 2014

    Report

    Report Number
    1525712-2014-06380
    Event Type
    Malfunction
    Date Received
    September 26, 2014
    Report Date
    September 5, 2014
    Manufacturer
    UNKNOWN
    Product Code
    FSA
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WV, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    FACILITY REPORTED THAT THE BOOM ON A (B)(4) PATIENT LIFT BENT AND THE RESIDENT FELL. THE RESIDENT WAS NOT HURT BUT THE TWO EMPLOYEES WERE HURT. NO INFORMATION AVAILABLE ON THE INJURIES OR MEDICAL INTERVENTION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    600617 NON AC-POWERED PATIENT LIFT 880.5510 FSA UNKNOWN RPL450

    Patients

    Seq Age Sex Outcome Treatment
    1 Other