FDA Adverse Event
Summary report: N
DAILY ACTIVITY ASSIST DEVICES
MDR report key: 4201690
·
Received October 27, 2014
Report
- Report Number
- 1531186-2014-05088
- Date Received
- October 27, 2014
- Report Date
- October 6, 2014
- Manufacturer
- JIANGSU YUYUE MEDICAL EQUIPMENT & SUPPLY CO., LTD
- Product Code
- ILS
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- UT, US
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
IT WAS REPORTED THAT THE FOOTREST ON THE 6891 COMMODE BROKE OFF.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 682482 | DAILY ACTIVITY ASSIST DEVICES | 890.5050 | ILS | JIANGSU YUYUE MEDICAL EQUIPMENT & SUPPLY CO., LTD | 6891 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |