FDA Adverse Event
Malfunction
Summary report: N
DAILY ACTIVITY ASSIST DEVICES
MDR report key: 3103490
·
Received May 9, 2013
Report
- Report Number
- 9616091-2013-00785
- Event Type
- Malfunction
- Date Received
- May 9, 2013
- Report Date
- April 15, 2013
- Manufacturer
- INVAMEX
- Product Code
- ILS
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
THE DEALER REPORTED THAT AN UNKNOWN INVAMEX COMMODE SEAT WAS CRACKING AT THE SEAM. THIS ISSUE COULD CAUSE INJURY TO THE USER OR THEY COULD FALL WHEN USING THE COMMODE SHOULD THE SEAT CRACK IN HALF.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 203961 | DAILY ACTIVITY ASSIST DEVICES | 890.5050 | ILS | INVAMEX | UNKNOWN |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |