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 |