BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL WALKER, ROLLATOR

    MDR report key: 3100746 · Received May 8, 2013

    Report

    Report Number
    1531186-2013-01961
    Date Received
    May 8, 2013
    Report Date
    April 12, 2013
    Manufacturer
    UNKNOWN
    Product Code
    ITJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    VA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATES LEG BROKE OFF.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    201889 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ UNKNOWN 6240-5F

    Patients

    Seq Age Sex Outcome Treatment
    1 Other