FDA Adverse Event
Malfunction
Summary report: N
DAILY ACTIVITY ASSIST DEVICES
MDR report key: 3173935
·
Received June 17, 2013
Report
- Report Number
- 1525712-2013-04724
- Event Type
- Malfunction
- Date Received
- June 17, 2013
- Report Date
- May 21, 2013
- Manufacturer
- UNKNOWN
- Product Code
- ILS
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TN, US
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
CRACKED SEAT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 273734 | DAILY ACTIVITY ASSIST DEVICES | 890.5050 | ILS | UNKNOWN | UNKNOWN |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |