FDA Adverse Event
Summary report: N
MECHANICAL WALKER, ROLLATOR
MDR report key: 2840992
·
Received November 20, 2012
Report
- Report Number
- 1531186-2012-01416
- Date Received
- November 20, 2012
- Report Date
- November 17, 2012
- Manufacturer
- CONSMA
- Product Code
- ITJ
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- VT, US
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
DEALER STATED THAT THE BRAKE CABLE IS NO LONGER ATTACHED TO THE HANDLE. IN SPEAKING WITH THE REPORTER IT WAS LEARNED THAT THERE WAS NO HARM AND THE REPAIR HAS BEEN COMPLETED WITHOUT FURTHER INCIDENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | MECHANICAL WALKER, ROLLATOR | 890.3825 | ITJ | CONSMA | 65650 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 52 YR | Other |