BEUDAMED
    FDA Adverse Event Other Summary report: N

    GOLVO

    MDR report key: 694249 · Received March 29, 2006

    Report

    Report Number
    1225750-2006-00002
    Event Type
    Other
    Date Received
    March 29, 2006
    Date of Event
    December 21, 2005
    Report Date
    March 29, 2006
    Manufacturer
    LIKO AB
    Product Code
    FSA
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    PA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    ON DECEMBER 21, 2005 WHILE TRANSFERRING A RESIDENT FROM BED TO CHAIR, USING A GOLVO 7007, THE RESIDENT PUCHES THEMSELVES FORWARD AND FELL OUT OF THE FRONT OF THE SLING. THE RESIDENT HIT HER HEAD AND RECEIVED A LACERATION. RESIDENT WAS TREATED AT A LOCAL HOSP AND RETURNED TO THE FACILITY SAME DAY. DURING A VISIT TO THE FACILITY IN MARCH 2006, OUR LIKO REP. WAS INFORMED OF THIS INCIDENT FOR THE FIRST TIME. THE LIFT WAS INSPECTED WITH NO SIGNS OF MALFUNCTION OR FAILURE OF ANY TYPE. THE SLING WAS COMPLETELY INTACT WITH NO SIGNS OF TEAR, WEAR OR BREAKDOWN. THE ONLY WAY EVENTS DESCRIBED IN THE REPORT COULD BE RECREATED WAS IF THE SLING WAS USED. AT THE TIME OF THE VISIT, LIKO WAS INFORMED THAT THE RESIDENT INVOLVED HAD PASSED AWAY IN THE WEEK FOLLOWING THE INCIDENT. PER THE FACILITY, DEATH WAS NOT RELATED TO THE INCIDENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 GOLVO PATIENT LIFT/HOIST FSA LIKO AB GOLVO 7007ES *

    Patients

    Seq Age Sex Outcome Treatment
    1 85 YR Other