BEUDAMED
    FDA Adverse Event Other Summary report: N

    PAL PRO-1 LIFT

    MDR report key: 45801 · Received October 31, 1996

    Report

    Report Number
    MW1010188
    Event Type
    Other
    Date Received
    October 31, 1996
    Date of Event
    October 13, 1996
    Report Date
    October 24, 1996
    Manufacturer
    SUNRISE MACHINE AND TOOL, INC.
    Product Code
    FSA
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MN, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    RESIDENT WAS BEING TRANSFERRED WITH THE MECHANICAL LIFT. AS RESIDENT WAS LIFTED FROM CHAIR TO BED, THE BAR THAT HOLDS THE STRAPS BROKE APART FROM THE LIFT AND THE RESIDENT FELL TO THE FLOOR, SUPINE, HITTING THE BACK OF HER HEAD. 4 CM LACERATION WAS SUSTAINED TO THE RIGHT PARIETO-OCCIPITAL SCALP. 10/13/96 C-SPINE X-RAY APPEAR NEGATIVE FOR FRACTURES.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PAL PRO-1 LIFT TOTAL BODY LIFT FSA SUNRISE MACHINE AND TOOL, INC. PRO-1-R *

    Patients

    Seq Age Sex Outcome Treatment
    1 62 YR Other