BEUDAMED
    FDA Adverse Event Summary report: N

    WHEELCHAIR ACCESSORY

    MDR report key: 3092785 · Received May 3, 2013

    Report

    Report Number
    1531186-2013-01894
    Date Received
    May 3, 2013
    Report Date
    April 9, 2013
    Manufacturer
    NEW PROKIN
    Product Code
    INE
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    THE PROVIDER STATED THE SLING RIPPED ON THE SIDE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    194865 WHEELCHAIR ACCESSORY 890.3910 INE NEW PROKIN R111

    Patients

    Seq Age Sex Outcome Treatment
    1 Other