FDA Adverse Event Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 3941175 · Received July 17, 2014

Report

Report Number
1531186-2014-02586
Date Received
July 17, 2014
Report Date
June 11, 2014
Manufacturer
UNKNOWN
Product Code
ILS
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

DEALER STATED FRAME IS BENT AT LEG.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
419434 DAILY ACTIVITY ASSIST DEVICES 890.5050 ILS UNKNOWN 6599

Patients

Seq Age Sex Outcome Treatment
1 Other