BEUDAMED
    FDA Adverse Event Other Summary report: N

    AMBULIFT C-3

    MDR report key: 52210 · Received November 25, 1996

    Report

    Report Number
    52210
    Event Type
    Other
    Date Received
    November 25, 1996
    Date of Event
    November 13, 1996
    Report Date
    November 25, 1996
    Manufacturer
    ARJO-CENTURY INC.
    Product Code
    FSA
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    NE, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    THIS RESIDENT BEING TRANSFERRED FROM WHEELCHAIR TO BED WITH C-3 LIFT. BEGAN TO TIP/SLIDE BACKWARDS, HEAD FIRST. NURSING ASST CAUGHT THE RESIDENT BUT HE DID HIT HEAD ON FLOOR. MINIMAL BLEEDING FROM NICKEL-SIZE AREA ON BACK OF HEAD. AFTER ANALYSIS OF ACCIDENT THE STAFF DISCOVERED THAT POSITIONING OF THE SLING BAR DETERMINES BALANCE OF THE RESIDENT, AND THAT THE HOOK OF THE SLING BAR MUST BE AWAY FROM THE RESIDENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 AMBULIFT C-3 MECHANICAL SLING LIFT FSA ARJO-CENTURY INC. C-3 *

    Patients

    Seq Age Sex Outcome Treatment
    1 87 YR Other