FDA Adverse Event Summary report: N

MECHANICAL WALKER, ROLLATOR

MDR report key: 3970402 · Received July 31, 2014

Report

Report Number
1531186-2014-02933
Date Received
July 31, 2014
Report Date
June 25, 2014
Manufacturer
KENSTONE METAL
Product Code
ITJ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PER PROVIDER THE REAR WHEEL IS SPLIT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
447839 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ KENSTONE METAL 66550

Patients

Seq Age Sex Outcome Treatment
1 Other