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 |