BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ETAC SWIFT MOBIL

    MDR report key: 2890577 · Received November 19, 2012

    Report

    Report Number
    3008986539-2012-00074
    Event Type
    Malfunction
    Date Received
    November 19, 2012
    Date of Event
    October 5, 2012
    Report Date
    October 19, 2012
    Manufacturer
    ETAC SUPPLY CENTER AB
    Product Code
    INM
    PMA / PMN Number
    EXEMPT
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SW
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    A (ONE) FRONT CASTOR OF THE SHOWER CHAIR CAME LOOSE. PT IS SITTING IN THE CHAIR AND IS WEARING A SAFETY BELT. THE ASSISTANT MANAGES TO GET HOLD OF THE PT. NO INJURY WAS REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ETAC SWIFT MOBIL CHAIR, WITH CASTERS - INM INM ETAC SUPPLY CENTER AB 80209412 NA

    Patients

    Seq Age Sex Outcome Treatment
    1