BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL WALKER, ROLLATOR

    MDR report key: 2893874 · Received January 2, 2013

    Report

    Report Number
    1531186-2013-00021
    Date Received
    January 2, 2013
    Report Date
    January 2, 2013
    Manufacturer
    CONSMA
    Product Code
    ITJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MS, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    ON (B)(6) -THE DEALER REPORTED THAT THE 65851B ROLLATOR BACK OF THE WHEEL WELD WAS BROKEN. THERE WAS NO PATIENT INJURY REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    476 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ CONSMA 65851B

    Patients

    Seq Age Sex Outcome Treatment
    1 Other