BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL WALKER, ROLLATOR

    MDR report key: 3110165 · Received May 13, 2013

    Report

    Report Number
    1525712-2013-03758
    Event Type
    Malfunction
    Date Received
    May 13, 2013
    Report Date
    April 17, 2013
    Manufacturer
    UNKNOWN
    Product Code
    ITJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    FACILITY CALLED IN AND SAID WALKER/ROLLATOR WAS NOT WORKING (NOT SURE WHICH). WHEELS BROKE. TRIED TO CALL ENDUSER AND NUMBER WAS INVALID.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    211079 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ UNKNOWN UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 Other