BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    DAILY ACTIVITY ASSIST DEVICES

    MDR report key: 3961390 · Received July 28, 2014

    Report

    Report Number
    1525712-2014-04045
    Event Type
    Malfunction
    Date Received
    July 28, 2014
    Report Date
    June 19, 2014
    Manufacturer
    UNKNOWN
    Product Code
    ILS
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    FRONT AND REAR CROSS BRACE HAS SURFACE RUST.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    437751 DAILY ACTIVITY ASSIST DEVICES 890.5050 ILS UNKNOWN 9630-1

    Patients

    Seq Age Sex Outcome Treatment
    1 Other