BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    DAILY ACTIVITY ASSIST DEVICES

    MDR report key: 3180963 · Received June 20, 2013

    Report

    Report Number
    1525712-2013-04874
    Event Type
    Malfunction
    Date Received
    June 20, 2013
    Report Date
    May 24, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    IKX
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CT, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    CUSTOMER STATES THE REAR WHEEL IS WOBBLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    279818 DAILY ACTIVITY ASSIST DEVICES 890.5050 IKX INVACARE TAYLOR STREET 6495

    Patients

    Seq Age Sex Outcome Treatment
    1 Other