BEUDAMED
    FDA Adverse Event Injury Summary report: N

    DRIVE ROLLATOR WALKER

    MDR report key: 20360491 · Received October 2, 2024

    Report

    Report Number
    MW5160486
    Event Type
    Injury
    Date Received
    October 2, 2024
    Date of Event
    September 20, 2024
    Report Date
    September 27, 2024
    Manufacturer
    MEDICAL DEPOT INC. DBA DRIVE DEVILBISS HEALTHCARE
    Product Code
    ITJ
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    PATIENT FAMILY MEMBER OR FRIEND
    Health Professional
    *

    Narratives

    Description of Event or Problem · 0

    I WAS ASSISTING MY MOTHER FROM A SEATED POSITION TO A STANDING POSITION USING HER WALKER AND THE FRONT RIGHT WHEEL COMPONENT COMPLETELY BROKE OFF CAUSING THE FRONT OF THE WALKER TO SHIFT FORWARD ABRUPTLY. THIS COULD HAVE RESULTED IN A FALL AND PROBABLE HEAD INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    2602400 DRIVE ROLLATOR WALKER WALKER, MECHANICAL ITJ MEDICAL DEPOT INC. DBA DRIVE DEVILBISS HEALTHCARE R728RD

    Patients

    Seq Age Sex Outcome Treatment
    1 86 YR Female Life Threatening CRANBERRY.| D-MANNOSE.| GLIPIZIDE.| GLUCOCIL.| IRON.| LYRICA.| MELATONIN.| METOPROLOL.| MULTIVITAMINS.| POTASSIUM.| PROBIOTICS.| SEROQUEL.| VICTOZA.| ZETIA.