FDA Adverse Event Malfunction Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 3133149 · Received May 29, 2013

Report

Report Number
9616091-2013-00903
Event Type
Malfunction
Date Received
May 29, 2013
Report Date
May 2, 2013
Manufacturer
INVAMEX
Product Code
ILS
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
PATIENT FAMILY MEMBER OR FRIEND

Narratives

Description of Event or Problem · 1

PER PROVIDER, THE SEAT IS CRACKED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
235320 DAILY ACTIVITY ASSIST DEVICES 890.5050 ILS INVAMEX 9630-4

Patients

Seq Age Sex Outcome Treatment
1 Other