BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL WALKER, ROLLATOR

    MDR report key: 3884398 · Received June 19, 2014

    Report

    Report Number
    1531186-2014-02176
    Date Received
    June 19, 2014
    Report Date
    May 20, 2014
    Manufacturer
    CONSMA
    Product Code
    ITJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MN, US
    Reporter Occupation
    PATIENT FAMILY MEMBER OR FRIEND

    Narratives

    Description of Event or Problem · 1

    THE END USER'S CHILD STATES THE WHEEL ON AN UNKNOWN ROLLATOR BROKE OFF.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    362012 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ CONSMA UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 Other