BEUDAMED
    FDA Adverse Event Summary report: N

    DAILY ACTIVITY ASSIST DEVICES

    MDR report key: 4140750 · Received October 3, 2014

    Report

    Report Number
    1531186-2014-04689
    Date Received
    October 3, 2014
    Report Date
    September 17, 2014
    Manufacturer
    UNKNOWN
    Product Code
    IKX
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MI, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    THE END USER STATES THE FRONT CASTER IS BROKEN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    620461 DAILY ACTIVITY ASSIST DEVICES 890.5050 IKX UNKNOWN 6795

    Patients

    Seq Age Sex Outcome Treatment
    1 Other