FDA Adverse Event Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 3080518 · Received April 26, 2013

Report

Report Number
1531186-2013-01791
Date Received
April 26, 2013
Report Date
April 2, 2013
Manufacturer
POPULAR PLASTICS
Product Code
IKX
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

(B)(4). IT WAS REPORTED BY THE CONSUMER THAT THE 9781 SHOWER CHAIR LEG EXTENSION SUCTION CUPS WERE DETACHING FROM THE UNIT. THERE WAS NO INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
181108 DAILY ACTIVITY ASSIST DEVICES 890.5050 IKX POPULAR PLASTICS 9781

Patients

Seq Age Sex Outcome Treatment
1 55 Other