FDA Adverse Event Summary report: N

SLEEVED JACKET

MDR report key: 85145 · Received February 15, 1995

Report

Report Number
85145
Date Received
February 15, 1995
Date of Event
September 28, 1994
Report Date
February 3, 1995
Manufacturer
SKIL-CARE CORP.
Product Code
FMQ
Report Source
User Facility report
Reporter Location
GA, US
Reporter Occupation
INVALID DATA

Narratives

Description of Event or Problem · 1

PT WAS SITTING IN HER ROOM IN A WHEELCHAIR, RESTRAINED BY A SLEEVED JACKET, 4-POINT RESTRAINT WITH ZIPPERED BACK, WHICH HAD BEEN ORDERED BY HER ATTENDING PHYSICIAN. AT APPROX 7:40 A.M. ON 9/28/94, SHE WAS DISCOVERED WITH HER WHEELCHAIR TURNED PARTIALLY OVER AND THE PT IN A SITTING POSITION, HALF ON THE FLOOR AND HALF IN THE WHEELCHAIR, FACING FORWARD. THE VEST RESTRAINT HAD SIFTED UPWARD AROUND HER NECK, RESULTING IN COMPRESSIVE NECK INJURIES. CPR WAS IMMEDIATELY STARTED UPON DISCOVERY AND CONTINUED UNTIL STOPPED ON ORDERS OF THE ATTENDING PHYSICIAN. CORONER WAS CALLED AND CAME IMMEDIATELY TO THE NURSING HOME, WHERE HE PRONOUNCED THE PT DEAD. HE SENT THE BODY FOR AUTOPSY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SLEEVED JACKET 4-POINT RESTRAINT WITH ZIPPERED BACK FMQ SKIL-CARE CORP. 3050 MEDIUM NA

Patients

Seq Age Sex Outcome Treatment
1 73 YR