FDA Adverse Event Summary report: N

MECHANICAL WALKER, ROLLATOR

MDR report key: 3970432 · Received July 31, 2014

Report

Report Number
1531186-2014-02936
Date Received
July 31, 2014
Report Date
June 25, 2014
Manufacturer
UNKNOWN
Product Code
ITJ
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

PER PROVIDER, CROSSBRACE IS BROKEN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
447885 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ UNKNOWN 65650R

Patients

Seq Age Sex Outcome Treatment
1 Other