FDA Adverse Event Malfunction Summary report: N

MECHANICAL WALKER, ROLLATOR

MDR report key: 2990642 · Received March 5, 2013

Report

Report Number
1525712-2013-01675
Event Type
Malfunction
Date Received
March 5, 2013
Report Date
February 8, 2013
Manufacturer
UNKNOWN
Product Code
ITJ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

(B)(4). IT WAS REPORTED BY THE CONSUMER THAT THE UNSPECIFIED MODEL ROLLATOR RIGHT BRAKE CABLE WAS BROKEN. THERE WAS NO PATIENT INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
93183 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ UNKNOWN UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Other