FDA Adverse Event Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 4131156 · Received October 1, 2014

Report

Report Number
1531186-2014-04540
Date Received
October 1, 2014
Report Date
September 9, 2014
Manufacturer
UNKNOWN
Product Code
IKX
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PER PROVIDER; FRAME BENT UNDER SEAT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
612927 DAILY ACTIVITY ASSIST DEVICES 890.5050 IKX UNKNOWN 96-2

Patients

Seq Age Sex Outcome Treatment
1 Other