UNK

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1998-08-26 for UNK manufactured by Unk.

Event Text Entries

[21586649] Pt sustained fall from wheelchair while restrained with buckle type seat belt. When incident reviewed a piece of the buckle appears to have broken off. Pt required emergency room evaluation and sutures to hand laceration. Hospital admission was not needed.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number184430
MDR Report Key184430
Date Received1998-08-26
Date of Report1998-08-24
Date of Event1998-08-14
Date Facility Aware1998-08-14
Report Date1998-08-24
Date Added to Maude1998-08-31
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameUNK
Generic NameSEAT BELT TYPE RESTRAINT
Product CodeIQB
Date Received1998-08-26
Model NumberUNK
Catalog NumberUNK
Lot NumberUNK
ID NumberUNK
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeUNKNOWN
Implant FlagN
Date RemovedU
Device Sequence No1
Device Event Key179279
ManufacturerUNK
Manufacturer AddressUNK UNK *


Patients

Patient NumberTreatmentOutcomeDate
101. Other 1998-08-26

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