BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL WALKER, ROLLATOR

    MDR report key: 3160577 · Received June 10, 2013

    Report

    Report Number
    1525712-2013-04514
    Event Type
    Malfunction
    Date Received
    June 10, 2013
    Report Date
    May 13, 2013
    Manufacturer
    UNKNOWN
    Product Code
    ITJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MS, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    CONSUMER'S DAUGHTER STATES THAT THE SNAP BUTTON ONE OF THE LEFT REAR LEG HAS BROKEN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    259984 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ UNKNOWN 6291-3F

    Patients

    Seq Age Sex Outcome Treatment
    1 Other