FDA Adverse Event Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 2455325 · Received February 16, 2012

Report

Report Number
1525712-2012-00265
Date Received
February 16, 2012
Date of Event
January 27, 2012
Report Date
February 15, 2012
Manufacturer
UNKNOWN
Product Code
IKX
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
PATIENT FAMILY MEMBER OR FRIEND

Narratives

Description of Event or Problem · 1

CONSUMER ALLEGES HUSBAND WAS SITTING ON THE SHOWER CHAIR AND THE SEAT CRACKED IN TWO. NO INJURY ALLEGED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DAILY ACTIVITY ASSIST DEVICES 890.5050 IKX UNKNOWN 9781

Patients

Seq Age Sex Outcome Treatment
1 68 Other