MAUDE Adverse Event Report: GOLDEN TECHNOLOGIES, INC GOLDEN POWER LIFT AND RECLINE CHAIR; CHAIR, POSITIONING, ELECTRIC

Model Number PR761 MLA STD JBO.

Device Problems Patient-Device Incompatibility (2682); Material Protrusion/Extrusion (2979)

Patient Problems Pain (1994); Numbness (2415)

Event Date 06/01/2021

Event Type  Injury  

Event Description

Pieces of angle iron popped through covering on my lift chair.That made contact pressure on my shoulder and back.Causing excruciating pain and numbness.Everytime the seller tries to fix the same problem with foam padding and noodle looking foam.The problem is a frame not padding.I've requested my money to be refunded, only to be ignored.This problem began within two weeks of purchase date of (b)(6) 2021.At this point i'm sleeping on the couch again, when i specifically bought this chair to sleep in, to assist with my copd and acid reflux.Fda safety report id# (b)(4).

• Brand Name: GOLDEN POWER LIFT AND RECLINE CHAIR
• Type of Device: CHAIR, POSITIONING, ELECTRIC
• Manufacturer (Section D): GOLDEN TECHNOLOGIES, INC
• MDR Report Key: 12365328
• MDR Text Key: 268247450
• Report Number: MW5103478
• Device Sequence Number: 1
• Product Code: INO
• Reporter Country Code: US
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Voluntary
• Reporter Occupation: Patient
• Type of Report: Initial
• Report Date: 08/21/2021

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 08/24/2021
• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: Yes
• Device Operator: No Information
• Device Model Number: PR761 MLA STD JBO.
• Was Device Available for Evaluation?: Yes
• Was Device Evaluated by Manufacturer?: No Information
• Type of Device Usage: N
• Patient Sequence Number: 1
• Patient Outcome(s): Disability
• Patient Age: 62 YR
• Patient Weight: 122