BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL WALKER, ROLLATOR

    MDR report key: 3090489 · Received May 2, 2013

    Report

    Report Number
    1531186-2013-01872
    Date Received
    May 2, 2013
    Report Date
    April 9, 2013
    Manufacturer
    UNKNOWN
    Product Code
    ITJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    (B)(4). NO SERIOUS INJURY ALLEGED. MALFUNCTION ALLEGED. THE PROVIDER STATED THE ROLLATOR HAS A BENT FRAME. MDR FILED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    192882 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ UNKNOWN 65350GR

    Patients

    Seq Age Sex Outcome Treatment
    1 Other