BEUDAMED
    FDA Adverse Event Summary report: N

    DAILY ACTIVITY ASSIST DEVICES

    MDR report key: 3944438 · Received July 18, 2014

    Report

    Report Number
    1531186-2014-02611
    Date Received
    July 18, 2014
    Report Date
    June 11, 2014
    Manufacturer
    DAIGLER KUNSTSTOFFSPRITZEREI GMBH
    Product Code
    IKX
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TN, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PER PROVIDER, DEALER REPORTS THE DEVICES PLASTIC TUBE HAS SNAPPED OFF.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    422079 DAILY ACTIVITY ASSIST DEVICES 890.5050 IKX DAIGLER KUNSTSTOFFSPRITZEREI GMBH H112-5

    Patients

    Seq Age Sex Outcome Treatment
    1 Other