FDA Adverse Event Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 3181860 · Received June 21, 2013

Report

Report Number
1531186-2013-02730
Date Received
June 21, 2013
Report Date
May 23, 2013
Manufacturer
UNKNOWN
Product Code
IKX
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PROVIDER STATES SEAT IS RIPPED AT THE SEAM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
281999 DAILY ACTIVITY ASSIST DEVICES 890.5050 IKX UNKNOWN MARINER

Patients

Seq Age Sex Outcome Treatment
1 45 Other