FDA Adverse Event Malfunction Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 3160560 · Received June 10, 2013

Report

Report Number
9616091-2013-00969
Event Type
Malfunction
Date Received
June 10, 2013
Report Date
May 13, 2013
Manufacturer
INVAMEX
Product Code
ILS
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PROVIDER STATES LID/SEAT ON A 9650-4 COMMODE CRACKED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
259874 DAILY ACTIVITY ASSIST DEVICES 890.5050 ILS INVAMEX 9650-4

Patients

Seq Age Sex Outcome Treatment
1 Other