BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL WALKER, ROLLATOR

    MDR report key: 3971491 · Received July 31, 2014

    Report

    Report Number
    1531186-2014-02928
    Date Received
    July 31, 2014
    Report Date
    June 25, 2014
    Manufacturer
    UNKNOWN
    Product Code
    ITJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    PER CUSTOMER STATES THE REAR RIGHT WHEEL IS SPLIT/CRACKED IN TWO PLACES. SHE STATES SHE IS STILL USING THE PRODUCT. CUSTOMER IS UNAWARE OF HOW IT GOT DAMAGED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    447425 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ UNKNOWN 66550

    Patients

    Seq Age Sex Outcome Treatment
    1 Other