BEUDAMED
    FDA Adverse Event Summary report: N

    DAILY ACTIVITY ASSIST DEVICES

    MDR report key: 3133323 · Received May 29, 2013

    Report

    Report Number
    1531186-2013-02345
    Date Received
    May 29, 2013
    Report Date
    May 1, 2013
    Manufacturer
    UNKNOWN
    Product Code
    ILS
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATES SEAT AND LID BROKE WHERE IT ATTACHES TO THE COMMODE FRAME.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    236845 DAILY ACTIVITY ASSIST DEVICES 890.5050 ILS UNKNOWN 9830-4

    Patients

    Seq Age Sex Outcome Treatment
    1 Other