FDA Adverse Event Malfunction Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 3964528 · Received July 29, 2014

Report

Report Number
9616091-2014-01334
Event Type
Malfunction
Date Received
July 29, 2014
Date of Event
June 20, 2014
Report Date
June 20, 2014
Manufacturer
INVAMEX
Product Code
ILS
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

DEALER STATED FRAME IS DAMAGE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
441222 DAILY ACTIVITY ASSIST DEVICES 890.5050 ILS INVAMEX 9650-4

Patients

Seq Age Sex Outcome Treatment
1 Other