BEUDAMED
    FDA Adverse Event Summary report: N

    DAILY ACTIVITY ASSIST DEVICES

    MDR report key: 2421025 · Received January 19, 2012

    Report

    Report Number
    1525712-2012-00120
    Date Received
    January 19, 2012
    Date of Event
    January 3, 2012
    Report Date
    January 18, 2012
    Manufacturer
    UNKNOWN
    Product Code
    IKX
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MO, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    CONSUMER WAS IN THE SHOWER AND THE LEGS OF THE SHOWER CHAIR ALLEGEDLY FOLDED IN. HE SAID IT WAS LIKE THE CENTER PORTION UNDER THE CHAIR ALLEGEDLY SPLIT. NO SERIOUS INJURY ALLEGED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DAILY ACTIVITY ASSIST DEVICES 890.5050 IKX UNKNOWN 91-2

    Patients

    Seq Age Sex Outcome Treatment
    1 Other