BEUDAMED
    FDA Adverse Event Death Summary report: N

    PAL

    MDR report key: 455290 · Received April 21, 2003

    Report

    Report Number
    2132280-2003-00003
    Event Type
    Death
    Date Received
    April 21, 2003
    Manufacturer
    SUNRISE MACHINE AND TOOL, INC.
    Product Code
    FSA
    Report Source
    Manufacturer report
    Reporter Location
    IA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    RESIDENT WAS BEING TRANSFERRED BU THE PAL LIFT. THREE (3) NURSING ASSISTANTS WERE IN THE RESIDENTS ROOM HELPING WITH THE TRNASFER. WHEN THE LIFT WAS MOVED AWAY FROM THE BED, ONE (1) STRAP OF THE SLING CAME LOOSE FROM THE PAL LIFT AND THE RESIDENT FELL TO THE FLOOR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PAL PROFESSION ASSISTANCE LIFT FSA SUNRISE MACHINE AND TOOL, INC. PC 350 S 4 *

    Patients

    Seq Age Sex Outcome Treatment
    1 89 YR Other