BEUDAMED
    FDA Adverse Event Injury Summary report: N

    TEMPO PPP

    MDR report key: 540150 · Received August 23, 2004

    Report

    Report Number
    9617021-2004-00082
    Event Type
    Injury
    Date Received
    August 23, 2004
    Date of Event
    June 7, 2004
    Report Date
    July 13, 2004
    Manufacturer
    ARJO MED AB LTD.
    Product Code
    FSA
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    THE PT WAS BEING TRANSFERRED FROM THE BED TO THE WHEELCHAIR WHEN THE LEG STRAPS RELEASED AND THE PT FELL TO THE FLOOR. THE RESIDENT SUFFERED A HEAD LACERATION AND A SKIN TEAR TO THE RIGHT ELBOW.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TEMPO PPP PATIENT LIFT FSA ARJO MED AB LTD. KPBXXXX NA

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Required Intervention