BEUDAMED
    FDA Adverse Event Summary report: N

    DAILY ACTIVITY ASSIST DEVICES

    MDR report key: 3020161 · Received March 25, 2013

    Report

    Report Number
    1531186-2013-01261
    Date Received
    March 25, 2013
    Report Date
    February 26, 2013
    Manufacturer
    UNKNOWN
    Product Code
    IKX
    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

    (B)(4). NO SERIOUS INJURY ALLEGED. MALFUNCTION ALLEGED. END USER STATES THAT THE RIGGING DISCONNECTED FROM THE CHAIR ON THE RIGHT SIDE. MDR FILED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    121858 DAILY ACTIVITY ASSIST DEVICES 890.5050 IKX UNKNOWN 6795

    Patients

    Seq Age Sex Outcome Treatment
    1 Other