FDA Adverse Event Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 2844001 · Received November 23, 2012

Report

Report Number
1531186-2012-01459
Date Received
November 23, 2012
Report Date
November 23, 2012
Manufacturer
PINGHU WEIFENG MATERIAL TECHNOLOGY
Product Code
IKX
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
LA, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

DEALER STATES THAT THE SUCTION CUP CAME OFF.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DAILY ACTIVITY ASSIST DEVICES 890.5050 IKX PINGHU WEIFENG MATERIAL TECHNOLOGY 98071 PW120401

Patients

Seq Age Sex Outcome Treatment
1 Other