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 |