FDA Adverse Event Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 4112551 · Received September 24, 2014

Report

Report Number
1531186-2014-04350
Date Received
September 24, 2014
Report Date
September 3, 2014
Manufacturer
KENSTONE METAL
Product Code
IKX
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

FACILITY NURSE IS REPORTING THE LEFT BRAKE IS BROKEN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
593298 DAILY ACTIVITY ASSIST DEVICES 890.5050 IKX KENSTONE METAL 6795

Patients

Seq Age Sex Outcome Treatment
1 Other