BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    DAILY ACTIVITY ASSIST DEVICES

    MDR report key: 3955530 · Received July 24, 2014

    Report

    Report Number
    1525712-2014-03973
    Event Type
    Malfunction
    Date Received
    July 24, 2014
    Report Date
    June 18, 2014
    Manufacturer
    UNKNOWN
    Product Code
    IKX
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER STATES THE SCREW THAT ATTACHES THE BACK TO THE BENCH IS MISSING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    434574 DAILY ACTIVITY ASSIST DEVICES 890.5050 IKX UNKNOWN 9670

    Patients

    Seq Age Sex Outcome Treatment
    1 Other