inforMED
OtherBWP

@SHOE COVER, SMS, NON-SKIN,X-L S

Received Mar 23, 2009 · Event occurred Feb 18, 2009

Report 1417592-2009-00022 · MDR key 1351562

Device

Generic name

None

Model number

NON28859

Lot number

84105972-2

Product problems

  • Insufficient Device Problem Information

Patient

Not reported

  • Fall
  • Injury

Narrative

Description of Event or Problem

IT WAS REPORTED THAT AN EMPLOYEE WENT TO SIT ON A STOOL AND AS IT BEGAN TO ROLL AWAY, SHE SLIPPED AND FELL, INJURING HER BACK.

Additional Manufacturer Narrative

IT WAS REPORTED THAT A STAFF MEMBER FELL WHILE WEARING THE NON-SKID SHOE COVERS. THERE WAS NO WATER ON THE FLOOR. SHE APPARENTLY WENT TO SIT DOWN ON A STOOL AND THE STOOL BEGAN ROLLING. SHE TRIED TO BRACE HERSELF AND HER FEET SLID. SHE FELL AND SUFFERED A CONTUSION TO HER BACK. SHE WAS EVALUATED IN THE EMERGENCY ROOM. SHE IS RECEIVING PHYSICAL THERAPY. NO SAMPLE WAS PROVIDED FOR EVAL. SAMPLES FROM STOCK AS WELL AS SAMPLES FROM OTHER VENDORS HAVE BEEN SENT TO A TESTING HOUSE TO HAVE THE SLIP MEASURED PER ASTM F 1677. AT THIS TIME, NO ROOT CAUSE HAS BEEN IDENTIFIED AND NO CORRECTIVE ACTION IS INDICATED.