MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-12-10 for 59 T EZ GLIDE CHAIR 0731328 manufactured by Ferno-washington, Inc..
[130179897]
It was reported while transporting a patient the seat frame of the chair allegedly broke. The patient was properly restrained and no injuries occured; however, the patient was transferred to an alternate method to continue the transport.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1523574-2018-00041 |
| MDR Report Key | 8147294 |
| Date Received | 2018-12-10 |
| Date of Report | 2019-02-04 |
| Date of Event | 2018-11-17 |
| Date Mfgr Received | 2018-12-05 |
| Device Manufacturer Date | 2006-06-01 |
| Date Added to Maude | 2018-12-10 |
| 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 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MS. DAWN GREENE |
| Manufacturer Street | 70 WEIL WAY |
| Manufacturer City | WILMINGTON OH 45177 |
| Manufacturer Country | US |
| Manufacturer Postal | 45177 |
| Manufacturer Phone | 9372832900 |
| Manufacturer G1 | FERNO-WASHINGTON, INC. |
| Manufacturer Street | 70 WEIL WAY |
| Manufacturer City | WILMINGTON OH 45177 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 45177 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 0 |
| Brand Name | 59 T EZ GLIDE CHAIR |
| Generic Name | 59 T EZ GLIDE CHAIR |
| Product Code | FPP |
| Date Received | 2018-12-10 |
| Model Number | 0731328 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Age | DA |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | FERNO-WASHINGTON, INC. |
| Manufacturer Address | 70 WEIL WAY WILMINGTON OH 45177 US 45177 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2018-12-10 |