BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL WALKER, ROLLATOR

    MDR report key: 3090521 · Received May 2, 2013

    Report

    Report Number
    1531186-2013-01879
    Date Received
    May 2, 2013
    Report Date
    April 8, 2013
    Manufacturer
    CONSMA
    Product Code
    ITJ
    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

    DEALER STATES THE WELD THAT ATTACHES THE BACKREST TO THE FRAME BROKE OFF BUT THEY DON'T KNOW HOW.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    192036 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ CONSMA 65650

    Patients

    Seq Age Sex Outcome Treatment
    1 Other