FDA Adverse Event
Malfunction
Summary report: N
IMMERSION HYDROBATH
MDR report key: 3241875
·
Received July 22, 2013
Report
- Report Number
- 1219590-2013-00065
- Event Type
- Malfunction
- Date Received
- July 22, 2013
- Report Date
- July 3, 2013
- Manufacturer
- INVACARE CLEVELAND STREET
- Product Code
- ILJ
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- KS, US
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
PER (B)(6) AT (B)(6) TUB MODEL IH3750 SN# (B)(4) DOOR SEAL IS LEAKING; PER POLICY LIFETIME WARRANTY APPLIED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 341886 | IMMERSION HYDROBATH | 890.5100 | ILJ | INVACARE CLEVELAND STREET | IH3750 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |