FDA Adverse Event Malfunction Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 3910115 · Received July 2, 2014

Report

Report Number
9616091-2014-01096
Event Type
Malfunction
Date Received
July 2, 2014
Date of Event
May 28, 2014
Report Date
May 28, 2014
Manufacturer
INVAMEX
Product Code
ILS
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PER PROVIDER TOILET SEAT HAS CRACKED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
387266 DAILY ACTIVITY ASSIST DEVICES 890.5050 ILS INVAMEX 9630-4

Patients

Seq Age Sex Outcome Treatment
1 Other