FDA Adverse Event Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 2821854 · Received November 6, 2012

Report

Report Number
1531186-2012-01355
Date Received
November 6, 2012
Report Date
November 6, 2012
Manufacturer
PINGHU WEIFENG MATERIAL TECHNOLOGY
Product Code
IKX
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

(B)(4). NO SERIOUS INJURY ALLEGED. MALFUNCTION ALLEGED. CUSTOMER RECEIVED A TRANSFER BENCH AND IT WORKED WELL FOR A FEW MONTHS. AFER A FEW MONTHS OF USE THE CUSTOMER NOTICED THE SEAT HAS BEGUN TO CRACK. THE CUSTOMER IS WELL WITHIN THE 315 POUND WEIGHT CAPACITY, AT (B)(6), AND IS USING THE BENCH AS DIRECTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DAILY ACTIVITY ASSIST DEVICES 890.5050 IKX PINGHU WEIFENG MATERIAL TECHNOLOGY 98071

Patients

Seq Age Sex Outcome Treatment
1 68 Other