BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ETAC SWIFT MOBIL

    MDR report key: 2628695 · Received June 13, 2012

    Report

    Report Number
    3008986539-2012-00060
    Event Type
    Malfunction
    Date Received
    June 13, 2012
    Date of Event
    April 1, 2012
    Report Date
    April 11, 2012
    Manufacturer
    ETAC SUPPLY CENTER AB
    Product Code
    INM
    PMA / PMN Number
    EXEMPT
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SW
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    CASTER FELL OFF THE SHOWER CHAIR WHILE PT WAS SITTING IN THE CHAIR. THE PT HAD CARER BY HIS/HER SIDE. NO INJURY WAS REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ETAC SWIFT MOBIL CHAIR, WITH CASTERS - INM INM ETAC SUPPLY CENTER AB 80209460 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK