FDA Adverse Event
Malfunction
Summary report: N
DRIVE
MDR report key: 17404144
·
Received July 27, 2023
Report
- Report Number
- 3014644996-2023-00008
- Event Type
- Malfunction
- Date Received
- July 27, 2023
- Report Date
- July 27, 2023
- Manufacturer
- COM-DA HEALTHCARE CO.,LTD
- Product Code
- ILS
- UDI-DI
- 00822383247151
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- US
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
- Health Professional
- Yes
Narratives
Description of Event or Problem · 0
DRIVE DEVILBISS HEALTHCARE WAS NOTIFIED OF AN INCIDENT INVOLVING A BATH BENCH BY A PROVIDER, WHO STATED THAT THE END USER "WAS SITTING ON THE CHAIR AND ONE LEG JUST SNAPPED." THE END USER REPORTEDLY UNDERWENT AN X-RAY SCAN WHICH REVEALED NO INJURY. DRIVE IS CURRENTLY INVESTIGATING THE INCIDENT, INCLUDING ATTEMPTING TO RETRIEVE THE PRODUCT AND INSPECT IT, AND WILL FILE AN UPDATE IF ADDITIONAL INFORMATION BECOMES AVAILABLE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1222742 | DRIVE | BATH CHAIR | ILS | COM-DA HEALTHCARE CO.,LTD | RTL12505 | 00822383247151 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Unknown |