BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL WALKER, ROLLATOR

    MDR report key: 3910870 · Received July 2, 2014

    Report

    Report Number
    1531186-2014-02352
    Date Received
    July 2, 2014
    Date of Event
    May 31, 2014
    Report Date
    June 2, 2014
    Manufacturer
    DANYANG MAXTHAI MEDICAL EQUIPMENT
    Product Code
    ITJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TN, US
    Reporter Occupation
    PATIENT FAMILY MEMBER OR FRIEND

    Narratives

    Description of Event or Problem · 1

    END USER LOST HIS BALANCE AND HE FELL; WHEN HE FELL THE ROLLATOR BENT - ALLEGES THAT THE FRAME IS ALREADY BENT IN THE REAR AND IT SHOULDN'T BE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    388599 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ DANYANG MAXTHAI MEDICAL EQUIPMENT 65650

    Patients

    Seq Age Sex Outcome Treatment
    1 72 YR Other