BEUDAMED
    FDA Adverse Event Death Summary report: N

    HOVERMATT

    MDR report key: 4360671 · Received December 17, 2014

    Report

    Report Number
    MW5039708
    Event Type
    Death
    Date Received
    December 17, 2014
    Date of Event
    November 20, 2014
    Report Date
    December 17, 2014
    Product Code
    FRZ
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MO, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PATIENT ON EXCEL CARE ES BARIATRIC BED WITH HOVERMATT DEFLATED BETWEEN PATIENT AND MATTRESS. PATIENT STATED SHE WAS SLEEPING AND WOKE UP AS HER LEG SLIDE OUT OF BED AND HER ENTIRE BODY SLIDE OUT WITH IT. PATIENT YELLED FOR HELP AND STAFF FOUND HER ON THE FLOOR WITH THE HOVERMATT ON FLOOR WITH HER. THREE SIDE RAILS WERE UP. PATIENT WAS TAKEN PROVIDED EMERGENT CARE AND FILMS TAKEN. PATIENT WAS ABLE TO HAVE FRACTURES IMMEDIATELY REPAIRED DUE TO UNDERLYING ISSUES. PATIENT WAS ULTIMATELY TRANSFERRED TO (B)(6) WHERE SHE EXPIRED ON (B)(6) 2014.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    826649 HOVERMATT SAFE PATIENT HANDLING DEVICE FRZ

    Patients

    Seq Age Sex Outcome Treatment
    1 61 YR Death