LIFELINE PERSONAL RESPONSE SYSTEM FD100

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer report with the FDA on 2017-12-22 for LIFELINE PERSONAL RESPONSE SYSTEM FD100 manufactured by Lifeline, Inc..

Event Text Entries

[95600348] As reported to fda per 1220762-11-15-2017-001-r, the involved button is part of a field action on the part of the manufacturer. The involved button did not have the appropriate fall parameters. It is unclear from the information provided to the manufacturer if the button may have contributed to any injury the subscriber sustained. The involved button was still able to be depressed to summon help. Per autoalert help button, instructions for use (p/n 0940718 rev. 7) p. 10 the autoalert help button can detect most falls, providing an added layer of protection. If you think you need assistance, push your help button immediately to initiate the help call. Pushing the help button generates the help call immediately. P. 13 recommended usage push your autoalert help button any time you need help. If you fall and are able to, you should still push the autoalert button to send a help call right away. Per autoalert help button, instructions for use, p/n 0940718 rev. 7 p. 5 states: "in certain situations, the autoalert help button may not detect a fall. Some movements may not register as a fall and would not be detected. Examples include, but are not limited to: a gradual slide such as from a seated position; lowering oneself slowly to the ground (to brace the impact of a fall) , a fall from a height of less than 20 inches (0. 5 meters). "
Patient Sequence No: 1, Text Type: N, H10


[95600349] The subscriber was unable to provide a date of the fall. She stated she had fallen forward and was unable to move. She stated she was on the floor for 6 hours.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1220762-2017-00002
MDR Report Key7141825
Report SourceCONSUMER
Date Received2017-12-22
Date of Report2017-12-20
Date Mfgr Received2017-12-06
Device Manufacturer Date2017-09-21
Date Added to Maude2017-12-22
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMS. INGRID SAWVELLE
Manufacturer Street111 LAWRENCE ST.
Manufacturer CityFRAMINGHAM MA 01702
Manufacturer CountryUS
Manufacturer Postal01702
Manufacturer Phone5089881000
Manufacturer G1RESPIRONICS, INC.
Manufacturer Street312 ALVIN DRIVE
Manufacturer CityNEW KENSINGTON PA 15068
Manufacturer CountryUS
Manufacturer Postal Code15068
Single Use3
Remedial ActionRC
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameLIFELINE PERSONAL RESPONSE SYSTEM
Generic NameSYSTEM, COMMUNICATOR, POWERED
Product CodeILQ
Date Received2017-12-22
Returned To Mfg2017-12-06
Model NumberFD100
OperatorLAY USER/PATIENT
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerLIFELINE, INC.
Manufacturer Address111 LAWRENCE ST. FRAMINGHAM MA 01702 US 01702


Patients

Patient NumberTreatmentOutcomeDate
101. Hospitalization 2017-12-22

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