FDA Adverse Event Malfunction Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 3955197 · Received July 24, 2014

Report

Report Number
3007231105-2014-00035
Event Type
Malfunction
Date Received
July 24, 2014
Date of Event
June 17, 2014
Report Date
June 17, 2014
Manufacturer
AQUATEC OPERATIONS GMBH
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 COMMODE IS WOBBLY AND THE CONSUMER DOES NOT FEEL COMFORTABLE USING IT. NO ADDITIONAL INFORMATION PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
434237 DAILY ACTIVITY ASSIST DEVICES 890.5050 ILS AQUATEC OPERATIONS GMBH 9630-4

Patients

Seq Age Sex Outcome Treatment
1 Other