BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POOL HOIST MKI

    MDR report key: 421117 · Received October 8, 2002

    Report

    Report Number
    9617021-2002-00147
    Event Type
    Malfunction
    Date Received
    October 8, 2002
    Date of Event
    June 5, 2002
    Report Date
    July 19, 2002
    Manufacturer
    ARJO, LTD.
    Product Code
    FSA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    UK
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    THE PT HAD BEEN TRANSFERRED OUT OF THE POOL ONTO THE HOIST CHAIR AND SUB CHASSIS TO BE TAKEN TO THE TOILET. THE HOIST WAS PULLED BACKWARDS AND THE FRONT RIGHT-HAND CASTOR BECAME DETACHED AND THE TCS TILTED TO ONE SIDE. NO INJURIES WERE REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 POOL HOIST MKI POOL LIFT FSA ARJO, LTD. CUSTOM NA

    Patients

    Seq Age Sex Outcome Treatment
    1 29 YR