BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL WALKER, ROLLATOR

    MDR report key: 3747114 · Received April 11, 2014

    Report

    Report Number
    1525712-2014-01874
    Date Received
    April 11, 2014
    Date of Event
    December 25, 2013
    Report Date
    March 14, 2014
    Manufacturer
    UNKNOWN
    Product Code
    ITJ
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    ATTORNEY

    Narratives

    Description of Event or Problem · 1

    END USER ALLEGES DEFECTIVE ROLLATOR CAUSED SLIP/FALL ON SIDEWALK.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    220549 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ UNKNOWN UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 Other