FDA Adverse Event
Summary report: N
MECHANICAL WALKER, ROLLATOR
MDR report key: 3898097
·
Received June 26, 2014
Report
- Report Number
- 1531186-2014-02255
- Date Received
- June 26, 2014
- Report Date
- May 27, 2014
- Manufacturer
- CONSMA
- Product Code
- ITJ
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NY, US
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
DEALER ALLEGES THE CROSSBAR ON A (B)(4) ROLLATOR BROKE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 373965 | MECHANICAL WALKER, ROLLATOR | 890.3825 | ITJ | CONSMA | 66550 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 65 | Other |