BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MAXI 500

    MDR report key: 807461 · Received January 4, 2007

    Report

    Report Number
    9681684-2007-00001
    Event Type
    Malfunction
    Date Received
    January 4, 2007
    Date of Event
    December 10, 2006
    Report Date
    January 4, 2007
    Manufacturer
    BHM MEDICAL, INC.
    Product Code
    FSA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    VT, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    THE FACILITY REPORTS THE PATIENT WAS BEING LIFTED FROM THE CHAIR TO THE BED. WHEN THE PATIENT WAS BEING RAISED, THE CAREGIVER HEARD A SNAP AND THE PATIENT SLIPPED OUT OF THE SLING ONTO THE FLOOR, LANDING ON HER RIGHT SIDE. THE RIGHT LEG CLIP IS THE ONE THAT UNCLIPPED. THE PATIENT WAS BEING LIFTED IN AN EXTRA-LARGE SLING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MAXI 500 PATIENT LIFT FSA BHM MEDICAL, INC. KMXXXXX NA

    Patients

    Seq Age Sex Outcome Treatment
    1 *