BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL WALKER, ROLLATOR

    MDR report key: 4142714 · Received October 6, 2014

    Report

    Report Number
    1525712-2014-06697
    Event Type
    Malfunction
    Date Received
    October 6, 2014
    Report Date
    September 17, 2014
    Manufacturer
    UNKNOWN
    Product Code
    ITJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IL, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PER DEALER BROKEN SEAT FROM WEAR AND TEAR. DEALER STATES UNIT IS AROUND 6 YEARS OLD.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    623115 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ UNKNOWN SELFCARE

    Patients

    Seq Age Sex Outcome Treatment
    1 Other