FDA Adverse Event Summary report: N

MECHANICAL WALKER, ROLLATOR

MDR report key: 2905625 · Received January 9, 2013

Report

Report Number
1531186-2013-00129
Date Received
January 9, 2013
Report Date
January 9, 2013
Manufacturer
CONSMA
Product Code
ITJ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NV, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

MDR DECISION DATE: NO SERIOUS INJURY ALLEGED. MALFUNCTION ALLEGED. THE DEALER STATES THE RUBBER GASKET BETWEEN THE BACK AND REAR FRAME OF THE ARMS IS WORN. MDR FILED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
12645 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ CONSMA 65851B

Patients

Seq Age Sex Outcome Treatment
1 Other