BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL WALKER, ROLLATOR

    MDR report key: 3180988 · Received June 20, 2013

    Report

    Report Number
    1531186-2013-02713
    Date Received
    June 20, 2013
    Report Date
    May 24, 2013
    Manufacturer
    CONSMA
    Product Code
    ITJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATES THE FRAME BROKE ON A 65650 ROLLATOR AND THE CONSUMER FELL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    280743 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ CONSMA 65650

    Patients

    Seq Age Sex Outcome Treatment
    1 Other