BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL WALKER, ROLLATOR

    MDR report key: 3954451 · Received July 24, 2014

    Report

    Report Number
    1531186-2014-02774
    Date Received
    July 24, 2014
    Report Date
    June 18, 2014
    Manufacturer
    UNKNOWN
    Product Code
    ITJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    PER END-USER RIGHT FRONT FORK IS BROKEN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    434707 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ UNKNOWN 66500

    Patients

    Seq Age Sex Outcome Treatment
    1 Other