BEUDAMED
    FDA Adverse Event Summary report: N

    DAILY ACTIVITY ASSIST DEVICES

    MDR report key: 3951475 · Received July 22, 2014

    Report

    Report Number
    1531186-2014-02691
    Date Received
    July 22, 2014
    Date of Event
    June 17, 2014
    Report Date
    June 17, 2014
    Manufacturer
    UNKNOWN
    Product Code
    ILS
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATES THAT THE CONSUMER WAS SITTING HIS MARINER SHOWER CHAIR TODAY AND THE SEAT CRACKED IN HALF.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    428782 DAILY ACTIVITY ASSIST DEVICES 890.5050 ILS UNKNOWN 6895

    Patients

    Seq Age Sex Outcome Treatment
    1 Other