FDA Adverse Event Summary report: N

MECHANICAL WALKER, ROLLATOR

MDR report key: 4093416 · Received September 16, 2014

Report

Report Number
1531186-2014-04165
Date Received
September 16, 2014
Date of Event
August 26, 2014
Report Date
August 26, 2014
Manufacturer
UNKNOWN
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

IT WAS REPORTED BY THE PROVIDER THAT THE LEFT BRAKE CABLE SNAPPED. NO PATIENT INJURY REPORTED, NO ADDITIONAL INFORMATION PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
571811 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ UNKNOWN 66550

Patients

Seq Age Sex Outcome Treatment
1 Other