FDA Adverse Event
Summary report: N
DAILY ACTIVITY ASSIST DEVICES
MDR report key: 3787496
·
Received May 2, 2014
Report
- Report Number
- 1531186-2014-01609
- Date Received
- May 2, 2014
- Report Date
- March 25, 2014
- Manufacturer
- UNKNOWN
- Product Code
- IKX
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- OH, US
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
DEALER STATED THAT A RIVET HOLDING THE LEGS ONTO A (B)(4) SHOWER CHAIR AS BROKEN.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 265700 | DAILY ACTIVITY ASSIST DEVICES | 890.5050 | IKX | UNKNOWN | 96-2 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 90 | Other |