BEUDAMED
    FDA Adverse Event Other Summary report: N

    HOYER LIFT

    MDR report key: 591184 · Received April 12, 2005

    Report

    Report Number
    2182305-2005-00006
    Event Type
    Other
    Date Received
    April 12, 2005
    Date of Event
    March 14, 2005
    Report Date
    April 11, 2005
    Manufacturer
    SUNRISE MEDICAL LTC
    Product Code
    FSA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED TO THE MANUFACTURER BY FACILITY CALLED IN AND STATED THE ARM HAD BROKEN OFF AND A PT FELL. [BOOM DID NOT BRAKE AS FIRST DESCRIBED] THE LEFT CAME APART. C.N.A.'S HAD BOOM IN THE HIGH POSITION UP OVER THE BED LIFTING RESIDENT UP AND OUT OF THEIR BED. WHEN THE SCALE AND CRADLE CAME APART FROM THE BOOM AND FELL WITH RESIDENT STILL IN SLING. SCALE STILL ATTACHED TO THE CRADLE WHEN THIS HAPPENED. RESIDENT WAS SENT TO ER FOR X-RAYS AND OBSERAVATION; BRUISING AND BUMP TO HEAD, NO SERIOUS INJURIES REPORTED. RESIDENT SENT BACK TO FACILITY AND IS DOING FINE. SCALE MANUFACTURER NOTIFIED OF THIS INCIDENT. SUNRISE SALES REP WILL BE VISITING FACILITY WEEK OF 3/2005 TO EVALUATE LIFT AND TAKE PICTURES.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HOYER LIFT PT LIFTER FSA SUNRISE MEDICAL LTC HPL402 W/SCALE #59011A *

    Patients

    Seq Age Sex Outcome Treatment
    1 70 YR Other