MAUDE Adverse Event Report: PRIDE MOBILITY PRODUCTS PRIDE MOBILITY PRODUCTS; ELECTRIC POSITIONING CHAIR

Model Number LC105

Device Problem Appropriate Term/Code Not Available (3191)

Patient Problem Death (1802)

Event Date 04/09/2019

Event Type  Death  

Manufacturer Narrative

The death notated in this file is in reference to the dog.The device has not yet been made available for evaluation.Should further information or the device become available for evaluation, a follow-up report will then be issued.

Event Description

Consumer alleges her dog was sleeping under the lift chair when her mother in law put the chair in the down position allegedly killing the dog.

Event Description

Consumer alleges her dog was sleeping under the lift chair when her mother in law put the chair in the down position allegedly killing the dog.

Manufacturer Narrative

The device was returned and evaluated.Operator error.Failure to follow owner's manual/labeling.

• Brand Name: PRIDE MOBILITY PRODUCTS
• Type of Device: ELECTRIC POSITIONING CHAIR
• Manufacturer (Section D): PRIDE MOBILITY PRODUCTS; 401 york ave; duryea, pa PA 18642
• MDR Report Key: 8539604
• MDR Text Key: 142753378
• Report Number: 2530130-2019-00045
• Device Sequence Number: 1
• Product Code: INO
• Combination Product (y/n): N
• PMA/PMN Number: K070950
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: consumer
• Type of Report: Initial,Followup
• Report Date: 02/13/2020

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Device Operator: Lay User/Patient
• Device Model Number: LC105
• Device Catalogue Number: N/A
• Device Lot Number: N/A
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 01/21/2020
• Initial Date Manufacturer Received: 04/12/2019
• Initial Date FDA Received: 04/23/2019
• Supplement Dates Manufacturer Received: 04/12/2019
• Supplement Dates FDA Received: 02/18/2020
• Is This a Reprocessed and Reused Single-Use Device?: No
• Patient Sequence Number: 1
• Patient Outcome(s): Death