FDA Adverse Event Malfunction Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 3173965 · Received June 17, 2013

Report

Report Number
9616091-2013-01019
Event Type
Malfunction
Date Received
June 17, 2013
Report Date
May 21, 2013
Manufacturer
INVAMEX
Product Code
ILS
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PROVIDER STATES THE SEAT HAS CRACKED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
273807 DAILY ACTIVITY ASSIST DEVICES 890.5050 ILS INVAMEX UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Other