FDA Adverse Event Summary report: N

MECHANICAL WALKER, ROLLATOR

MDR report key: 3160644 · Received June 10, 2013

Report

Report Number
1531186-2013-02527
Date Received
June 10, 2013
Report Date
May 14, 2013
Manufacturer
UNKNOWN
Product Code
ITJ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

CONSUMER STATES THAT THE SCREWS FELL OUT OF THE SEAT ON THE ROLLATOR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
260563 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ UNKNOWN 65851R

Patients

Seq Age Sex Outcome Treatment
1 32 Other