BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    EZ LIFT

    MDR report key: 893044 · Received August 7, 2007

    Report

    Report Number
    MW5003370
    Event Type
    Malfunction
    Date Received
    August 7, 2007
    Date of Event
    July 24, 2007
    Report Date
    August 7, 2007
    Manufacturer
    EZ-WAY, INC.
    Product Code
    FSA
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MN, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    EZ LIFT SLING STRAPS BROKE BILATERALLY CAUSING RESIDENT TO FALL TO THE FLOOR. RESIDENT HIT HEAD AND UPPER BACK.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 EZ LIFT EZ LIFT SLING LARGE FSA EZ-WAY, INC. 50312 WASHED AWAY

    Patients

    Seq Age Sex Outcome Treatment
    1 87 YR