BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    DAILY ACTIVITY ASSIST DEVICES

    MDR report key: 2991804 · Received March 6, 2013

    Report

    Report Number
    1525712-2013-01685
    Event Type
    Malfunction
    Date Received
    March 6, 2013
    Report Date
    February 8, 2013
    Manufacturer
    UNKNOWN
    Product Code
    ILS
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    (B)(4). NO SERIOUS INJURY ALLEGED. MALFUNCTION ALLEGED. PER DEALER THE SEAT IS CRACKED IN THE BACK OF THE SEAT AND IS PINCHING THE CONSUMER. MDR FILED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    95124 DAILY ACTIVITY ASSIST DEVICES 890.5050 ILS UNKNOWN UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 Other