BEUDAMED
    FDA Adverse Event Other Summary report: N

    TOTAL LIFT II - CHAIR / RECLINER

    MDR report key: 611129 · Received May 26, 2005

    Report

    Report Number
    611129
    Event Type
    Other
    Date Received
    May 26, 2005
    Date of Event
    April 18, 2005
    Report Date
    May 18, 2005
    Manufacturer
    WY EAST MEDICAL CORP.
    Product Code
    FSA
    Report Source
    User Facility report
    Reporter Location
    AZ, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    A CONFUSED PATIENT WAS PLACED IN A TOTAL LIFT II CHAIR. THE 2 VELCRO STRAPS WERE SECURED ON THE PATIENT. THE NURSE LEFT ROOM AND THE PATIENT WAS ABLE TO PULL THE SAFETY BELTS OFF AND FELL FOWARD OFF THE CHAIR ONTO THE FLOOR. THE PATIENT SUFFERED A LACERATION TO THE FOREHEAD. THE CHAIR MAY NEED A DIFFERENT TYPE OF BELT THAT CAN BE SECURED AND WHICH IS NOT EASILY ACCESSIBLE TO THE PATIENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TOTAL LIFT II - CHAIR / RECLINER CHAIR FSA WY EAST MEDICAL CORP. * *

    Patients

    Seq Age Sex Outcome Treatment
    1 79 YR