BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    P.V.C. SHOWER CHAIR

    MDR report key: 225174 · Received May 25, 1999

    Report

    Report Number
    MW1016389
    Event Type
    Malfunction
    Date Received
    May 25, 1999
    Date of Event
    May 13, 1999
    Report Date
    May 23, 1999
    Manufacturer
    THE ANTHROS MEDICAL GROUP
    Product Code
    INM
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NY, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    RESIDENT WAS GIVEN A SHOWER WHEN CHAIR WHEELS "POPPED" OUT. SENT TO MAINTENANCE, UNABLE TO FIX, SCRAPPED. CAPACITY 300 LBS, RESIDENT WEIGHED 144.9 LBS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 P.V.C. SHOWER CHAIR SHOWER CHAIR INM THE ANTHROS MEDICAL GROUP * *

    Patients

    Seq Age Sex Outcome Treatment
    1 74 YR Other