BEUDAMED
    FDA Adverse Event Death Summary report: N

    E.M. ADAMS CO., INC

    MDR report key: 460837 · Received May 9, 2003

    Report

    Report Number
    1054786-2003-00001
    Event Type
    Death
    Date Received
    May 9, 2003
    Date of Event
    October 17, 1999
    Report Date
    April 29, 2003
    Manufacturer
    E.M. ADAMS CO., INC.
    Product Code
    FMQ
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PATIENT OBSERVED OUT OF BED WHILE IN RESTRAINTS. ONE END OF THE RESTRAINT WAS NOTED TO BE LOOSE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 E.M. ADAMS CO., INC VEST JACKET FMQ E.M. ADAMS CO., INC. 26-0355 *

    Patients

    Seq Age Sex Outcome Treatment
    1 84 YR Death