FDA Adverse Event
Death
Summary report: N
MAXI MOVE
MDR report key: 4184983
·
Received October 17, 2014
Report
- Report Number
- 9681684-2014-00075
- Event Type
- Death
- Date Received
- October 17, 2014
- Report Date
- September 17, 2014
- Manufacturer
- ARJOHUNTLEIGH MAGOG INC.
- Product Code
- FSA
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- GA, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
(B)(4). ADDITIONAL INFORMATION WILL BE PROVIDED UPON CONCLUSION OF THE MANUFACTURER'S INVESTIGATION. (B)(4).
Description of Event or Problem · 1
AT THIS TIME, THE ONLY INFORMATION THAT HAS BEEN PROVIDED TO ARJOHUNTLEIGH IS NOTIFICATION BY THE PATIENT'S ESTATE OF A WRONGFUL DEATH LAW SUIT AGAINST A PARTS MANUFACTURER IN WHICH MAXI MOVE WAS LISTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 660856 | MAXI MOVE | FSA | ARJOHUNTLEIGH MAGOG INC. | KMCSUN-D |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Death |