FDA Adverse Event Malfunction Summary report: N

INNOVATIVE PRODUCTS UNLIMITED, INC.

MDR report key: 1651129 · Received March 31, 2010

Report

Report Number
1833497-2010-00006
Event Type
Malfunction
Date Received
March 31, 2010
Date of Event
March 24, 2010
Report Date
March 30, 2010
Manufacturer
INNOVATIVE PRODUCTS UNLIMITED, INC.
Product Code
INN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CT, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

A SHOWER CHAIR BROKE AT THE "T" BELOW THE SEAT CAUSING THE CHAIR TO COLLAPSE RESULTING IN A PT INJURY. THE CHAIR WAS BUILT ON OR BEFORE OCTOBER 2002. THE AGE OF THE CHAIR IS UNK, AND WAS NOT RETURNED FOR OBSERVATION. NO FURTHER ACTION REQUIRED.

Description of Event or Problem · 1

A SHOWER CHAIR BROKE AT THE "T" BELOW THE SEAT CAUSING THE CHAIR TO COLLAPSE RESULTING IN A PT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INNOVATIVE PRODUCTS UNLIMITED, INC. SHOWER CHAIR INN INNOVATIVE PRODUCTS UNLIMITED, INC. SC200

Patients

Seq Age Sex Outcome Treatment
1 UNK