FDA Adverse Event
Malfunction
Summary report: N
DAILY ACTIVITY ASSIST DEVICES
MDR report key: 3981203
·
Received August 5, 2014
Report
- Report Number
- 9616091-2014-01425
- Event Type
- Malfunction
- Date Received
- August 5, 2014
- Report Date
- June 20, 2014
- Manufacturer
- INVAMEX
- Product Code
- ILS
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- AR, US
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
PER PROVIDER, THE FRAME ON THE (B)(4) COMMODE IS BENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 458477 | DAILY ACTIVITY ASSIST DEVICES | 890.5050 | ILS | INVAMEX | 9630-1 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |