BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL WALKER, ROLLATOR

    MDR report key: 3872209 · Received June 13, 2014

    Report

    Report Number
    1531186-2014-02120
    Date Received
    June 13, 2014
    Date of Event
    May 18, 2014
    Report Date
    May 18, 2014
    Manufacturer
    UNKNOWN
    Product Code
    ITJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    CUSTOMER STATES CASTER BROKE OFF.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    349748 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ UNKNOWN 65851R

    Patients

    Seq Age Sex Outcome Treatment
    1 Other