FDA Adverse Event
Summary report: N
MECHANICAL WALKER, ROLLATOR
MDR report key: 2843084
·
Received November 21, 2012
Report
- Report Number
- 1531186-2012-01419
- Date Received
- November 21, 2012
- Date of Event
- October 15, 2012
- Report Date
- November 18, 2012
- Manufacturer
- DANYANG MAXTHAI MEDICAL EQUIPMENT
- Product Code
- ITJ
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- WI, US
- Reporter Occupation
- PATIENT
Narratives
Description of Event or Problem · 1
USER'S SON CALLED STATING THAT THE BRAKES ON HER 65650R ROLLATOR ALLEGEDLY ARE NOT LOCKING.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | MECHANICAL WALKER, ROLLATOR | 890.3825 | ITJ | DANYANG MAXTHAI MEDICAL EQUIPMENT | 65650R |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 83 MO | Other |