BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CHAIR COMMODE

    MDR report key: 1064611 · Received June 19, 2008

    Report

    Report Number
    1064611
    Event Type
    Injury
    Date Received
    June 19, 2008
    Date of Event
    August 11, 2007
    Report Date
    June 18, 2008
    Product Code
    INB
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    PA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PT FOUND ON FLOOR IN FRONT OF COMMODE CHAIR. UPON INVESTIGATION, FRONT RIGHT WHEEL FOUND TO BE BROKEN OFF CHAIR. PT FOR XRAY AND MRI FOR EVAL OF REPORTED RIGHT KNEE PAIN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CHAIR COMMODE INB UNK UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 55 YR Required Intervention