FDA Adverse Event Malfunction Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 3083510 · Received April 29, 2013

Report

Report Number
1525712-2013-03337
Event Type
Malfunction
Date Received
April 29, 2013
Report Date
April 3, 2013
Manufacturer
UNKNOWN
Product Code
ILS
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PROVIDER STATES SEAT CRACKED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
184816 DAILY ACTIVITY ASSIST DEVICES 890.5050 ILS UNKNOWN UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Other