FDA Adverse Event
Summary report: N
DAILY ACTIVITY ASSIST DEVICES
MDR report key: 2930673
·
Received January 28, 2013
Report
- Report Number
- 1531186-2013-00307
- Date Received
- January 28, 2013
- Report Date
- January 25, 2013
- Manufacturer
- JAN MAO
- Product Code
- ILS
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- UT, US
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
DEALER STATED THAT THE STEEL CLIP ON A 6497 HEAVY DUTY COMMODE ALLEGEDLY BROKE OFF.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 37260 | DAILY ACTIVITY ASSIST DEVICES | 890.5050 | ILS | JAN MAO | 6497 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |