FDA Adverse Event Malfunction Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 3123230 · Received May 21, 2013

Report

Report Number
9616091-2013-00856
Event Type
Malfunction
Date Received
May 21, 2013
Date of Event
April 25, 2013
Report Date
April 25, 2013
Manufacturer
INVAMEX
Product Code
ILS
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PROVIDER STATES CRACKED SEAT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
224383 DAILY ACTIVITY ASSIST DEVICES 890.5050 ILS INVAMEX 9650-4

Patients

Seq Age Sex Outcome Treatment
1 Other