BEUDAMED
    FDA Adverse Event Death Summary report: N

    APOLLO

    MDR report key: 820519 · Received February 8, 2007

    Report

    Report Number
    820519
    Event Type
    Death
    Date Received
    February 8, 2007
    Date of Event
    January 28, 2007
    Report Date
    February 1, 2007
    Manufacturer
    APOLLO CORP.
    Product Code
    ILJ
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    LA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    RESIDENT WAS ON 2 P.C. WHIRLPOOL SYSTEM CHAIR. CHAIR SLID OFF BASE WITH RESIDENT IN IT. RESIDENT HIT HEAD ON FLOOR. CNA WAS PUSHING RESIDENT BACK TO ROOM. APOLLO BATHING SYSTEM #3411 - #3000 LEVEL GLIDE TRANSFER SYSTEM - MOBILE BASE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 APOLLO BATHING SYSTEM ILJ APOLLO CORP. 3000 - LEVEL GLIDE TRANSFER SYSTEM *

    Patients

    Seq Age Sex Outcome Treatment
    1 80 YR Death