BEUDAMED
    FDA Adverse Event Summary report: N

    DAILY ACTIVITY ASSIST DEVICES

    MDR report key: 3171358 · Received June 14, 2013

    Report

    Report Number
    1531186-2013-02625
    Date Received
    June 14, 2013
    Report Date
    May 20, 2013
    Manufacturer
    PINGHU WEIFENG MATERIAL TECHNOLOGY
    Product Code
    IKX
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4). THE PATIENT HIT HER SIDE AND BACK AND NEEDED THE RESCUE SQUAD TO HELP GET HER UP. SHE STATES SHE IS BRUISED.

    Description of Event or Problem · 1

    A BATH BENCH W/O BACK THAT COLLAPSED WHILE IN USE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    271256 DAILY ACTIVITY ASSIST DEVICES 890.5050 IKX PINGHU WEIFENG MATERIAL TECHNOLOGY 91-2

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention