FDA Adverse Event Malfunction Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 2960054 · Received February 13, 2013

Report

Report Number
9616091-2013-00236
Event Type
Malfunction
Date Received
February 13, 2013
Date of Event
January 10, 2013
Report Date
February 13, 2013
Manufacturer
INVAMEX
Product Code
ILS
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

DEALER STATES SEAT CRACKED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
62404 DAILY ACTIVITY ASSIST DEVICES 890.5050 ILS INVAMEX 9630-1

Patients

Seq Age Sex Outcome Treatment
1 85 Other