BEUDAMED
    FDA Adverse Event Death Summary report: N

    CHAIR HYDROLICS SIMULTANEOUS RECLINE

    MDR report key: 560885 · Received December 17, 2004

    Report

    Report Number
    560885
    Event Type
    Death
    Date Received
    December 17, 2004
    Date of Event
    November 28, 2004
    Report Date
    December 9, 2004
    Manufacturer
    STERIS CORPORATION
    Product Code
    BYN
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    IL, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT WAS TRANSFERRED FROM THE BED TO THE CARDIAC CHAIR. DURING THE PROCESS, THE PT FELL TO THE FLOOR. UPON REVIEW WITH THE STAFF, IT APPEARED THE CHAIR BRAKE MAY HAVE BEEN "TOE TOUCHED" BY THE STAFF WHEN REACHING OVER THE PT. THIS MAY HAVE ALLOWED THE CHAIR TO MOVE AWAY FROM THE BED. PT TRANSFERRED TO REFERRING HOSP FOR FURTHER CARE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CHAIR HYDROLICS SIMULTANEOUS RECLINE CARDIAC CHAIR BYN STERIS CORPORATION * *

    Patients

    Seq Age Sex Outcome Treatment
    1 77 YR Death