FDA Adverse Event Summary report: N

MECHANICAL WALKER, ROLLATOR

MDR report key: 3033944 · Received April 3, 2013

Report

Report Number
1531186-2013-01394
Date Received
April 3, 2013
Report Date
March 7, 2013
Manufacturer
GENTEEL HOMECARE PRODUCTS
Product Code
ITJ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

(B)(4). NO SERIOUS INJURY ALLEGED. MALFUNCTION ALLEGED. PROVIDER STATES LEFT HAND CLIP, THAT LOCKS SWING AWAY SIDE FRAME TO FRONT FRAME, FELL OUT AND IS MISSING. MDR FILED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
137477 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ GENTEEL HOMECARE PRODUCTS 6300-ATA

Patients

Seq Age Sex Outcome Treatment
1 Other