BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HOYER STATURE

    MDR report key: 6995655 · Received November 2, 2017

    Report

    Report Number
    3010605276-2017-00005
    Event Type
    Injury
    Date Received
    November 2, 2017
    Date of Event
    September 21, 2017
    Report Date
    November 1, 2017
    Manufacturer
    APEX HEALTH CARE MFG., INC.
    Product Code
    FSA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    US
    Reporter Occupation
    SERVICE PERSONNEL

    Narratives

    Description of Event or Problem · 1

    WE RECEIVED THE MEDWATCH FORM 3500A FROM OUR CUSTOMER: JOERNS HEALTHCARE AND IT STATED AS BELOW: IT WAS REPORTED TO THE MANUFACTURER BY THE END USER, PER THE END USER, STAFF WAS LIFTING THE PATIENT AND THE LEG OF THE LIFT SNAPPED OFF AND THE PATIENT FEEL TO THE FLOOR. THE PATIENT WAS SENT TO THE HOSPITAL AND SUSTAINED A FRACTURED RIGHT HIP. IT WAS ENTERED INTO JOERNS SYSTEM TO HAVE THE LIFT RETURNED TO JOERNS FOR INVESTIGATION. AS OF THIS WRITING, WE HAVE NOT YET OBTAINED THE UPDATE NEWS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    776118 HOYER STATURE PATIENT LIFT, PRODUCT CODE: FSA FSA APEX HEALTH CARE MFG., INC. HOY-STATUREWSC

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization