BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LUMEX

    MDR report key: 510598 · Received January 28, 2004

    Report

    Report Number
    MW1030999
    Event Type
    Injury
    Date Received
    January 28, 2004
    Date of Event
    January 18, 2004
    Report Date
    January 28, 2004
    Manufacturer
    LUMEX, INC.
    Product Code
    FRJ
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    VA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    RIGHT 4TH TOE CAUGHT IN LUMEN RECLINING CHAIR (PREFERRED CHAIR SERIES MODEL #6746600) CAUSING AMPUTATION OF DISTAL PART OF TOE WHEN ATTEMPTING TO DISLODGE TOE. RESIDENT TRANSPORTED "911" TO EMERGENCY ROOM. TREATMENT INCLUDED X-RAY OF RIGHT FOOT, TETANUS INJECTION, IV ANTIBOTIC (ANCEF) AND PAIN MEDICATION. AREA TREATED BY ORTHOPEDIST WITH 3-SUTURE CLOSURE TO SITE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LUMEX GERI-RECLINER (3-POSITION) FRJ LUMEX, INC. 674G600 *

    Patients

    Seq Age Sex Outcome Treatment
    1 75 YR Required Intervention