FDA Adverse Event Summary report: N

MECHANICAL WALKER, ROLLATOR

MDR report key: 3851414 · Received June 5, 2014

Report

Report Number
1531186-2014-02098
Date Received
June 5, 2014
Date of Event
April 22, 2014
Report Date
April 22, 2014
Manufacturer
DANYANG MAXTHAI MEDICAL EQUIPMENT
Product Code
ITJ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AL, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

THE LEFT BRAKE IS NOT WORKING ON A (B)(4) ROLLATOR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
329191 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ DANYANG MAXTHAI MEDICAL EQUIPMENT 65650

Patients

Seq Age Sex Outcome Treatment
1 72 MO Other