FDA Adverse Event Malfunction Summary report: N

MECHANICAL WALKER, ROLLATOR

MDR report key: 3935138 · Received July 15, 2014

Report

Report Number
1525712-2014-03687
Event Type
Malfunction
Date Received
July 15, 2014
Report Date
June 9, 2014
Manufacturer
UNKNOWN
Product Code
ITJ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PER PROVIDER ORIGINAL 861497294, CUSTOMER STATES THESE KNOBS FOR THE ARM HEIGHT ADJUSTMENT WERE NOT IN THE BOX WITH THE PRODUCT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
411992 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ UNKNOWN SELFCARE

Patients

Seq Age Sex Outcome Treatment
1 Other