FDA Adverse Event Summary report: N

DAILY ACTIVITY ASSIST DEVICES

MDR report key: 4201674 · Received October 27, 2014

Report

Report Number
1531186-2014-05089
Date Received
October 27, 2014
Report Date
October 3, 2014
Manufacturer
KENSTONE METAL
Product Code
IKX
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PER CUSTOMER, THE SEAT HAS A CRACK IN IT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
682067 DAILY ACTIVITY ASSIST DEVICES 890.5050 IKX KENSTONE METAL 6795

Patients

Seq Age Sex Outcome Treatment
1 Other