FDA Adverse Event
Malfunction
Summary report: N
IMMERSION HYDROBATH
MDR report key: 3176187
·
Received June 18, 2013
Report
- Report Number
- 1219590-2013-00045
- Event Type
- Malfunction
- Date Received
- June 18, 2013
- Report Date
- May 22, 2013
- Manufacturer
- INVACARE CLEVELAND STREET
- Product Code
- ILJ
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- AR, US
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
PROVIDER STATES LIFETIME WARRANTY TUB SEAL LEAK. P/N 1143641.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 274886 | IMMERSION HYDROBATH | 890.5100 | ILJ | INVACARE CLEVELAND STREET | IH3652G |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |