BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL WALKER, ROLLATOR

    MDR report key: 3953096 · Received July 23, 2014

    Report

    Report Number
    1531186-2014-02722
    Date Received
    July 23, 2014
    Date of Event
    June 6, 2014
    Report Date
    June 13, 2014
    Manufacturer
    CONSMA
    Product Code
    ITJ
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SD, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER STATES ROLLATOR BROKEN AT CROSSBAR WELD BY WHERE SEAT IS ATTACHED ON THE RIGHT SIDE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    432207 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ CONSMA 65650R

    Patients

    Seq Age Sex Outcome Treatment
    1 Other