BEUDAMED
    FDA Adverse Event Summary report: N

    WHEELCHAIR COMPONENTS

    MDR report key: 2500845 · Received March 23, 2012

    Report

    Report Number
    1531186-2012-00061
    Date Received
    March 23, 2012
    Report Date
    March 22, 2012
    Manufacturer
    POPULAR PLASTICS
    Product Code
    KNN
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IL, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    CUSTOMER ALLEGED MANUAL ELR PLASTIC CALF PAD RECEIVER SNAPPED ON TWO ELRS. NO INJURY ALLEGED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 WHEELCHAIR COMPONENTS 890.3920 KNN POPULAR PLASTICS T94HE

    Patients

    Seq Age Sex Outcome Treatment
    1 Other