BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL WALKER, ROLLATOR

    MDR report key: 3222279 · Received July 12, 2013

    Report

    Report Number
    1531186-2013-03105
    Date Received
    July 12, 2013
    Report Date
    June 21, 2013
    Manufacturer
    UNKNOWN
    Product Code
    ITJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    THE PROVIDER REPORTED THE BRAKES ON THE 65851R ROLLATOR ARE NOT ENGAGING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    324395 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ UNKNOWN 65851R

    Patients

    Seq Age Sex Outcome Treatment
    1 Other