BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    UNK

    MDR report key: 621655 · Received June 29, 2005

    Report

    Report Number
    621655
    Event Type
    Malfunction
    Date Received
    June 29, 2005
    Date of Event
    June 25, 2005
    Report Date
    June 29, 2005
    Manufacturer
    INVACARE CORPORATION
    Product Code
    ILZ
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    IL, US

    Narratives

    Description of Event or Problem · 1

    THE PATIENT INVOLVED IS A HOMECARE PATIENT. THE EQUIPMENT INVOLVED WAS RENTED BY THE PATIENT FROM AN OUTSIDE VENDOR. THE PATIENT WAS BEING HELPED INTO BED BY A FAMILY MEMBER. THE PATIENT WAS USING THE BED TRAPEZE. THE BED TRAPEZE BROKE AND THE PATIENT FELL DOWN ON THE BED RAIL ON THE RIGHT HIP. HOMECARE PERSONNEL CONTACT FACILITY, BUT THE VENDOR DECLINED TO PROVIDE THE MODEL NUMBER OR MANUFACTURER OF THE TRAPEZE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 UNK BED TRAPEZE ILZ INVACARE CORPORATION * *

    Patients

    Seq Age Sex Outcome Treatment
    1 73 YR