BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL WALKER, ROLLATOR

    MDR report key: 3191688 · Received June 26, 2013

    Report

    Report Number
    1531186-2013-02804
    Date Received
    June 26, 2013
    Report Date
    May 30, 2013
    Manufacturer
    CONSMA
    Product Code
    ITJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATES FRAME BROKEN AT WELD ON LEFT SIDE. PRODUCT MODEL SHOWN IS INCORRECT IT SHOULD READ: 65350GR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    290379 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ CONSMA 63530GR

    Patients

    Seq Age Sex Outcome Treatment
    1 Other