FDA Adverse Event Malfunction Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 2328924 · Received November 9, 2011

Report

Report Number
9616091-2011-00072
Event Type
Malfunction
Date Received
November 9, 2011
Report Date
November 8, 2011
Manufacturer
INVAMEX
Product Code
INB
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

NO RMA HAS BEEN INITIATED FOR THIS ISSUE. MODEL 9650-4, SERIAL NUMBER/DATE CODE XXXX IS APPROXIMATELY XXXX AGE. THE USER MANUAL PART NUMBER 1023891 WAS ISSUED WITH THIS DEVICE. IT IS UNKNOWN IF THE CONSUMER HAS FULLY READ AND UNDERSTANDS THE USER MANUAL. DOCUMENTATION PROVIDES WARNINGS, CAUTIONS, AND INSTRUCTIONS FOR SAFELY USING THE DEVICE. IF THE CONSUMER DOES NOT UNDERSTAND THE WRITTEN WARNINGS, CAUTIONS OR INSTRUCTIONS THEN THEY SHOULD CONTACT INVACARE. THE CONSUMERS MEDICAL CONDITION, STABILITY AND MEDICATION REGIMEN ARE UNKNOWN . THE CONSUMERS AGE, HEIGHT AND WEIGHT ARE UNKNOWN. THE CONSUMERS TECHNIQUE WHILE USING THE DEVICE IS UNKNOWN. THE MAINTENANCE HISTORY OF THE DEVICE IS UNKNOWN.

Description of Event or Problem · 1

THE SEATS ARE ALLEGEDLY CRACKING ON THE COMMODES. THE DEALER ALLEGEDLY HAS BEEN RECEIVING MANY COMPLAINTS FROM CONSUMERS ABOUT THIS ISSUE WITHIN MONTHS OF USE AND SOME OF THE COMMODES ALLEGEDLY HAVE CRACKED SEATS OUT OF THE BOX. NO INJURY IS ALLEGED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DAILY ACTIVITY ASSIST DEVICES 890.5050 INB INVAMEX 9650-4

Patients

Seq Age Sex Outcome Treatment
1 Other