FDA Adverse Event Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 2895821 · Received January 3, 2013

Report

Report Number
1531186-2013-00034
Date Received
January 3, 2013
Report Date
January 3, 2013
Manufacturer
PINGHU WEIFENG MATERIAL TECHNOLOGY
Product Code
IKX
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
PATIENT

Narratives

Additional Manufacturer Narrative · 1

(B)(4). FOLLOW UP #001. INITIAL PR (B)(4) ISSUED MFR. REPORT # 1531186-2013-00034. END USER STATED DURING A FOLLOW UP CALL THAT THE SHOWER CHAIR IS NOT AN INVACARE PRODUCT. THE DEALER REFERRED HER TO INVACARE TO OBTAIN A SHOWER CHAIR FOR HER NEEDS. NON REPORTABLE EVENT - NOT AN INVACARE PRODUCT.

Description of Event or Problem · 1

CONSUMER STATED THE SEAT IS CRACKING FROM THE MIDDLE FRONT TO FRONT RIGHT LEG. THE END USER WILL BE ISSUED A SHOWER CHAIR WITH A WEIGHT CAPACITY OF 400. THIS UNIT HAS A WEIGHT CAPACITY OF 315 LBS. THE END USER WAS NOT HARMED OR INJURED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
3078 DAILY ACTIVITY ASSIST DEVICES 890.5050 IKX PINGHU WEIFENG MATERIAL TECHNOLOGY 96-2

Patients

Seq Age Sex Outcome Treatment
1 Other