BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL WALKER, ROLLATOR

    MDR report key: 4200293 · Received October 24, 2014

    Report

    Report Number
    1531186-2014-05075
    Date Received
    October 24, 2014
    Date of Event
    October 3, 2014
    Report Date
    October 2, 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

    PER DEALER, STATES THE ROLLATOR IS BROKEN AT A WELD NOT SURE WHERE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    679778 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ UNKNOWN 65650R

    Patients

    Seq Age Sex Outcome Treatment
    1 Other