FDA Adverse Event Summary report: N

MECHANICAL WALKER, ROLLATOR

MDR report key: 3946138 · Received July 21, 2014

Report

Report Number
1531186-2014-02619
Date Received
July 21, 2014
Report Date
June 11, 2014
Manufacturer
UNKNOWN
Product Code
ITJ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

DEALER STATES THE BACK RIGHT LEG SPRING IS BROKEN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
425045 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ UNKNOWN 6241-A

Patients

Seq Age Sex Outcome Treatment
1 Other