BEUDAMED
    FDA Adverse Event Injury Summary report: N

    SEF-LIFT

    MDR report key: 619410 · Received July 5, 2005

    Report

    Report Number
    1419652-2005-00002
    Event Type
    Injury
    Date Received
    July 5, 2005
    Date of Event
    May 24, 2005
    Report Date
    July 5, 2005
    Manufacturer
    ARJO, INC.
    Product Code
    FSA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    THE FACILITY REPORTS THE RESIDENT WAS ELEVATED IN A TUB LIFT CHAIR. RESIDENT WAS BUCKLED IN WHEN RAISED AND ICWERED INTO THE TUB. AFTER THE BATH, THE RESIDENT WAS RAISED AND TURNED OUT OF THE TUB. THE RESIDENT LEANED FORWARD; THE AIDE TRIED TO PUSH THEM BACK IN THE SEAT. THE RESIDENT SLID OUT OF THE CHAIR SUFFERING A FRACTURED PELVIS.

    Description of Event or Problem · 1

    THE FACILITY REPORTS THE RESIDENT WAS ELEVATED IN A TUB LIFT CHAIR. RESIDENT WAS BUCKLED IN WHEN RAISED AND LOWERED INTO THE TUB. AFTER THE BATH, THE RESIDENT WAS RAISED AND TURNED OUT OF THE TUBE. THE RESIDENT LEANED FORWARD; THE SIDE TRIED TO PUSH HER BACK IN THE SEAT. THE RESIDENT SLID OUT OF THE CHAIR. SUFFERING A FRACTURED PELVIS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SEF-LIFT PATIENT LIFT FSA ARJO, INC. 20XXXXX NA

    Patients

    Seq Age Sex Outcome Treatment
    1 87 YR Hospitalization| R