MAUDE Adverse Event Report: HILL-ROM, INC. LIKORALL 242; LIFT, PATIENT, CEILING MOUNTED

Model Number LILORALL 242

Device Problem Break (1069)

Patient Problem Fall (1848)

Event Date 02/12/2020

Event Type  malfunction  

Event Description

Overhead lift carriage pin sheared and lift is not functional.Lift system was involved in a patient fall.

• Brand Name: LIKORALL 242
• Type of Device: LIFT, PATIENT, CEILING MOUNTED
• Manufacturer (Section D): HILL-ROM, INC.; 1069 state route 46 east; batesville IN 47006
• MDR Report Key: 9877015
• MDR Text Key: 184867371
• Report Number: 9877015
• Device Sequence Number: 1
• Product Code: FNG
• Combination Product (y/n): N
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: User Facility
• Reporter Occupation: Risk Manager
• Type of Report: Initial
• Report Date: 02/21/2020

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Other
• Device Model Number: LILORALL 242
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: No
• Was the Report Sent to FDA?: Yes
• Date Report Sent to FDA: 02/21/2020
• Device Age: 12 YR
• Event Location: Hospital
• Date Report to Manufacturer: 03/25/2020
• Initial Date Manufacturer Received: Not provided
• Initial Date FDA Received: 03/25/2020
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: N
• Patient Sequence Number: 1
• Patient Age: 26645 DA
• Patient Weight: 80