FDA.reportPublic FDA data

MAUDE MDR 128991

MDR report key
128991
Report number
2183897-1997-00007
Event key
0
Event type
3
Date received
1997-10-21
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
17684AUTOMATIC VAN LIFTNELLCOR PURITAN BENNETTING7684NANAK900417NRN

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
11997-10-2101. R

Event Narratives#

D

Patient 1

REPORT OF ALLEGED "USER FRACTURED HER LEG WHILE GETTING OFF THE PLATFORM. SHE WOULD LOWER LIFT TO GROUND, THEN START TO OPERATE HER CHAIR TO GET OFF. SHE WOULD GET APPROX 3/4 OF THE WAY OFF, AND THE BACK PART OF HER CHAIR CAUGHT THE BARRIERS. SHE FELL OUT OF THE CHAIR AND BROKE HER LEG. SHE WAS NOT WEARING HER SEAT BELT AT THE TIME OF INCIDENT.