BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL WALKER, ROLLATOR

    MDR report key: 2802268 · Received October 23, 2012

    Report

    Report Number
    1531186-2012-01246
    Date Received
    October 23, 2012
    Report Date
    October 22, 2012
    Manufacturer
    SHUNLONG PHYSICAL THERAPY EQUIPMENT
    Product Code
    ITJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    DE, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    (B)(6) - THE DEALER REPORTED THAT THE 65550 ROLLATOR FRONT AND REAR TIRES HAVE SPLIT. THERE WERE NO INJURIES REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ SHUNLONG PHYSICAL THERAPY EQUIPMENT 65550

    Patients

    Seq Age Sex Outcome Treatment
    1 51 Other