FDA Adverse Event Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 3840844 · Received May 30, 2014

Report

Report Number
1531186-2014-01940
Date Received
May 30, 2014
Report Date
April 10, 2014
Manufacturer
UNKNOWN
Product Code
ILS
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

CONSUMER STATES THE LEFT ARM REST IS CRACKED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
318229 DAILY ACTIVITY ASSIST DEVICES 890.5050 ILS UNKNOWN 1392KD

Patients

Seq Age Sex Outcome Treatment
1 98 Other