FDA Adverse Event Summary report: N

MECHANICAL WALKER, ROLLATOR

MDR report key: 4150712 · Received October 8, 2014

Report

Report Number
1531186-2014-04765
Date Received
October 8, 2014
Report Date
September 16, 2014
Manufacturer
UNKNOWN
Product Code
ITJ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
ME, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

TBM STATES OUT OF BOX THE WHEELS ON THE ROLLATOR ARE WARPED. PROVIDER WANTS THE WHOLE ROLLATOR REPLACED INSTEAD OF JUST PARTS. NO ADDITIONAL INFORMATION PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
632780 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ UNKNOWN 65650

Patients

Seq Age Sex Outcome Treatment
1 Other