BEUDAMED
    FDA Adverse Event Death Summary report: N

    SKIL-CARE RESIDENT RELEASE BELT

    MDR report key: 541243 · Received August 26, 2004

    Report

    Report Number
    541243
    Event Type
    Death
    Date Received
    August 26, 2004
    Date of Event
    July 26, 2004
    Report Date
    August 26, 2004
    Manufacturer
    SKIL-CARE CORP.,
    Product Code
    KNN
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    VA, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    IN COURSE OF INVESTIGATING DEATH OF NURSING HOME RESIDENT, QUESTION WHETHER WHEELCHAIR SEAT BELT MAY HAVE LOOSENED WHEN IN USE AND MAY HAVE CAUSED OR CONTRIBUTED TO DEATH OF NURSING HOME RESIDENT IN WHEELCHAIR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SKIL-CARE RESIDENT RELEASE BELT WHEELCHAIR SEAT BELT KNN SKIL-CARE CORP., * *

    Patients

    Seq Age Sex Outcome Treatment
    1 78 YR Death