FDA Adverse Event Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 3180992 · Received June 20, 2013

Report

Report Number
1531186-2013-02715
Date Received
June 20, 2013
Report Date
May 24, 2013
Manufacturer
UNKNOWN
Product Code
IKX
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
LA, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PROVIDER STATES CUSTOMER FELL WHILE ON THE 96-2 SHOWER CHAIR; NO INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
280512 DAILY ACTIVITY ASSIST DEVICES 890.5050 IKX UNKNOWN 96-2

Patients

Seq Age Sex Outcome Treatment
1 Other