FDA Adverse Event Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 2890384 · Received December 29, 2012

Report

Report Number
1531186-2012-01910
Date Received
December 29, 2012
Report Date
December 29, 2012
Manufacturer
POPULAR PLASTICS
Product Code
IKX
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

CONSUMER ALLEGES THAT WHEN SHE APPLIES PRESSURE TO THE BACK OF THE CHAIR THE BACK POPS OFF. NO INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DAILY ACTIVITY ASSIST DEVICES 890.5050 IKX POPULAR PLASTICS 9670

Patients

Seq Age Sex Outcome Treatment
1 Other