BEUDAMED
    FDA Adverse Event Summary report: N

    DAILY ACTIVITY ASSIST DEVICES

    MDR report key: 3183695 · Received June 22, 2013

    Report

    Report Number
    1531186-2013-02755
    Date Received
    June 22, 2013
    Report Date
    May 28, 2013
    Manufacturer
    LERADO GLOBAL
    Product Code
    ILS
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IL, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATES CLAMP BROKE ON 1302RTS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    284223 DAILY ACTIVITY ASSIST DEVICES 890.5050 ILS LERADO GLOBAL 1302RTS

    Patients

    Seq Age Sex Outcome Treatment
    1 Other