BEUDAMED
    FDA Adverse Event Death Summary report: N

    PAL VOLARO

    MDR report key: 622757 · Received July 22, 2005

    Report

    Report Number
    2132280-2005-00006
    Event Type
    Death
    Date Received
    July 22, 2005
    Date of Event
    July 8, 2005
    Report Date
    July 12, 2005
    Manufacturer
    SUNRISE MACHINE AND TOOL, INC.
    Product Code
    FSA
    Report Source
    Manufacturer report
    Reporter Location
    MN, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    RESIDENT WAS BEING LIFTED USING A VOLARO LIFT. THE LEFT SIDE SLING ATTACHMENT CAME OUT OF HOOK CLIP AND THE RESIDENT FELL TO THE FLOOR. THE LEFT SIDE OF RESIDENT'S HEAD HIT THE FLOOR. THE RESIDENT WAS SENT TO THE HOSPITAL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PAL VOLARO FULL BODY LIFT FSA SUNRISE MACHINE AND TOOL, INC. PC45054 UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 84 YR Death