BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL WALKER, ROLLATOR

    MDR report key: 3013717 · Received March 20, 2013

    Report

    Report Number
    1531186-2013-01162
    Date Received
    March 20, 2013
    Date of Event
    February 21, 2013
    Report Date
    February 21, 2013
    Manufacturer
    UNKNOWN
    Product Code
    ITJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CO, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    THE DEALER REPORTED THAT A PLASTIC PIECE ON THE BRAKE WAS BROKEN WHICH COULD CAUSE INSTABILITY TO THE PRODUCT AND CAUSE THE USER TO FALL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    115159 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ UNKNOWN 65851B

    Patients

    Seq Age Sex Outcome Treatment
    1 Other