FDA Adverse Event Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 3200528 · Received July 1, 2013

Report

Report Number
1531186-2013-02894
Date Received
July 1, 2013
Report Date
June 6, 2013
Manufacturer
UNKNOWN
Product Code
IKX
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PROVIDER STATES REFERENCE ORDER (B)(4) UNDER SEAT FRAME BENT. (B)(6).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
298355 DAILY ACTIVITY ASSIST DEVICES 890.5050 IKX UNKNOWN 96-2

Patients

Seq Age Sex Outcome Treatment
1 27 Other