BEUDAMED
    FDA Adverse Event Summary report: N

    DAILY ACTIVITY ASSIST DEVICES

    MDR report key: 3051667 · Received April 10, 2013

    Report

    Report Number
    1531186-2013-01503
    Date Received
    April 10, 2013
    Report Date
    March 14, 2013
    Manufacturer
    JAN MAO
    Product Code
    ILS
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NJ, 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 THAT THE SEAT POPS OFF. MDR FILED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    153673 DAILY ACTIVITY ASSIST DEVICES 890.5050 ILS JAN MAO UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 Other