MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 08 report with the FDA on 2008-12-09 for MEDICAL CHAIR & TABLE 6905A-38 manufactured by Dk City.
[17731778]
The dealer states the consumer foot propelled the chair outside to have a cigarette. The consumer allegedly fell asleep with the lit cigarette and caught himself on fire, resulting in his death.
Patient Sequence No: 1, Text Type: D, B5
[17966664]
Pt was in hospice care. Propelled themselves outside in the mechanical gerri chair. User had reportedly had a cigarette fell asleep with lit cigarette and caught themselves on fire resulting in their death. No malfunction apparent.
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 1525712-2008-00135 |
| MDR Report Key | 1260607 |
| Report Source | 08 |
| Date Received | 2008-12-09 |
| Date of Report | 2008-12-09 |
| Date of Event | 2008-11-16 |
| Device Manufacturer Date | 2007-09-01 |
| Date Added to Maude | 2008-12-15 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | CARROLL MARTIN |
| Manufacturer Street | ONE INVACARE WAY |
| Manufacturer City | ELYRIA OH 44036 |
| Manufacturer Country | US |
| Manufacturer Postal | 44036 |
| Manufacturer Phone | 4403296356 |
| Manufacturer G1 | DK CITY |
| Manufacturer Street | NO 600 YONG SHENG RD |
| Manufacturer City | JIADING SHANGHAI |
| Manufacturer Country | CH |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | MEDICAL CHAIR & TABLE |
| Generic Name | 880.6140 |
| Product Code | FRJ |
| Date Received | 2008-12-09 |
| Model Number | 6905A-38 |
| Operator | LAY USER/PATIENT |
| Device Availability | N |
| Device Age | DA |
| Device Eval'ed by Mfgr | R |
| Implant Flag | N |
| Date Removed | B |
| Device Sequence No | 1 |
| Device Event Key | 1317319 |
| Manufacturer | DK CITY |
| Manufacturer Address | JIADING SHANGHAI CH |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Death | 2008-12-09 |