BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNKNOWN

    MDR report key: 4223930 · Received October 30, 2014

    Report

    Report Number
    4223930
    Event Type
    Injury
    Date Received
    October 30, 2014
    Date of Event
    October 20, 2014
    Report Date
    October 30, 2014
    Manufacturer
    UNKNOWN
    Product Code
    FPO
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    IN, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    RESIDENT ROLLED OFF SHOWER BED. LACERATION TO FOREHEAD, TO EMERGENCY ROOM FOR FEW SUTURES AND RETURNED TO FACILITY. UPON INVESTIGATION AFTER EVENT OCCURRED AND EQUIPMENT WAS INSPECTED, IT WAS DETERMINED THAT THE PIN WAS LOOSE AND NOT POSITIONED CORRECTLY IN LOCK OF SHOWER BED. PIN WAS NOT SECURELY INSERTED ALL THE WAY THROUGH. ALL SHOWER BEDS WERE INSPECTED BY MAINTENANCE AND PINS REPLACED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    696530 UNKNOWN SHOWER BED TRANSPORT FPO UNKNOWN UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 71 YR Other