FDA Adverse Event Summary report: N

MECHANICAL WALKER, ROLLATOR

MDR report key: 2970733 · Received February 20, 2013

Report

Report Number
1531186-2013-00683
Date Received
February 20, 2013
Report Date
February 20, 2013
Manufacturer
UNKNOWN
Product Code
ITJ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

(B)(6). NO SERIOUS INJURY ALLEGED. MALFUNCTION ALLEGED. DEALER STATES THAT THERE IS WEAR AT THE SCREW ON THE HANDLE. THE HANDLE IS SPLITTING. MDR FILED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
74769 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ UNKNOWN P429/2

Patients

Seq Age Sex Outcome Treatment
1 Other