FDA Adverse Event Other Summary report: N

40-OS CHAIR

MDR report key: 1023720 · Received March 28, 2008

Report

Report Number
1523574-2008-00005
Event Type
Other
Date Received
March 28, 2008
Date of Event
February 19, 2008
Report Date
March 24, 2008
Manufacturer
FERNO-WASHINGTON, INC.
Product Code
FPO
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

PRODUCT IS ELEVEN YEARS OLD. FATIGUE / AGE AND MAINTENANCE CONTRIBUTING FACTORS.

Description of Event or Problem · 1

USER REPORTED RIGHT LOWER SUPPORT BAR OF THE CHAIR DETACHED CAUSING THE CHAIR TO SHIFT TO THE LEFT. PT WAS MAINTAINED ON THE CHAIR. PT STATED SHE HAD MINOR DISCOMFORT IN THE RIGHT FLANK REGION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 40-OS CHAIR MODEL 40 CHAIR FPO FERNO-WASHINGTON, INC. 40-OS

Patients

Seq Age Sex Outcome Treatment
1 40 YR Other