BEUDAMED
    FDA Adverse Event Summary report: N

    DAILY ACTIVITY ASSIST DEVICES

    MDR report key: 3781065 · Received April 30, 2014

    Report

    Report Number
    1531186-2014-01579
    Date Received
    April 30, 2014
    Date of Event
    March 6, 2014
    Report Date
    March 26, 2014
    Manufacturer
    KENSTONE METAL
    Product Code
    IKX
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AZ, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER STATES THE BEARINGS ON FRONT CASTERS CAME APART AND THE END USER WAS NOT INJURED BUT FELL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    259780 DAILY ACTIVITY ASSIST DEVICES 890.5050 IKX KENSTONE METAL 6895

    Patients

    Seq Age Sex Outcome Treatment
    1 38 YR Other