BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    DAILY ACTIVITY ASSIST DEVICES

    MDR report key: 3114559 · Received May 15, 2013

    Report

    Report Number
    9616091-2013-00829
    Event Type
    Malfunction
    Date Received
    May 15, 2013
    Date of Event
    April 16, 2013
    Report Date
    April 18, 2013
    Manufacturer
    INVAMEX
    Product Code
    ILS
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SC, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATES SEAT IS CRACKED. (P/N 1112182).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    215644 DAILY ACTIVITY ASSIST DEVICES 890.5050 ILS INVAMEX 9360-4

    Patients

    Seq Age Sex Outcome Treatment
    1 83 Other