FDA Adverse Event Malfunction Summary report: N

MECHANICAL WALKER, ROLLATOR

MDR report key: 3123240 · Received May 21, 2013

Report

Report Number
1525712-2013-04023
Event Type
Malfunction
Date Received
May 21, 2013
Report Date
February 11, 2013
Manufacturer
UNKNOWN
Product Code
ITJ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MD, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

INVACARE AWARENESS DATE IS (B)(4) 2013. COMPLAINT WAS NOT GIVEN TO REGULATORY AFFAIRS FOR PROCESSING UNTIL (B)(4) 2013.

Description of Event or Problem · 1

THE DEALER REPORTED THAT THE SEAT ON THE ROLLATOR IS BROKEN. THIS ISSUE COULD CAUSE PRODUCT INSTABILITY AND THE ABILITY FOR THE SEAT TO MAINTAIN ITS WEIGHT BEARING CAPACITY, CAUSING THE USER TO FALL AND BE INJURED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
224436 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ UNKNOWN UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Other