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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: LIKO AB MULTIRALL 200; NON-AC POWERED PATIENT LIFT
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LIKO AB MULTIRALL 200; NON-AC POWERED PATIENT LIFT Back to Search Results
Model Number 3130001
Device Problems Break (1069); Component Falling (1105); Misassembled (1398); Component Missing (2306)
Patient Problem No Information (3190)
Event Date 07/09/2014
Event Type  Injury  
Event Description
It was reported to hill-rom that while moving a pt from the bed, the liftstrap of the overhead lift gave way.The pt fell to the floor with lift motor lowering on pt's abdominal area.The initial eval of the event implied that the strap was incorrectly inserted in the liftstrap connection and the blocking pin was missing.Lift was installed in the pt's room the day before the event.
 
Manufacturer Narrative
Hill-rom is currently executing an investigation of the event.A supplemental/follow up report will be submitted when the report is complete.
 
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Brand Name
MULTIRALL 200
Type of Device
NON-AC POWERED PATIENT LIFT
Manufacturer (Section D)
LIKO AB
nedre vagen 100
lulea 975 92
SW  975 92
Manufacturer Contact
joe fogel
nedre vagen 100
c157156
lulea 975 9-2
SW   975 92
20474700
MDR Report Key3964924
MDR Text Key4608593
Report Number8030916-2014-00059
Device Sequence Number1
Product Code FSA
Combination Product (y/n)N
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Company Representative
Reporter Occupation Not Applicable
Type of Report Initial
Report Date 07/15/2014
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received07/18/2014
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Other
Device Model Number3130001
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Date Manufacturer Received07/15/2014
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured12/01/2010
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Unknown
Patient Sequence Number1
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