BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    DAILY ACTIVITY ASSIST DEVICES

    MDR report key: 3830993 · Received May 23, 2014

    Report

    Report Number
    1525712-2014-02653
    Event Type
    Malfunction
    Date Received
    May 23, 2014
    Date of Event
    March 1, 2014
    Report Date
    April 11, 2014
    Manufacturer
    UNKNOWN
    Product Code
    ILS
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MO, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    END USER STATES THE SEAT CRACKED AND HAS PINCHED HIM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    307835 DAILY ACTIVITY ASSIST DEVICES 890.5050 ILS UNKNOWN UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 84 Other