BEUDAMED
    FDA Adverse Event Summary report: N

    DAILY ACTIVITY ASSIST DEVICES

    MDR report key: 4212422 · Received October 30, 2014

    Report

    Report Number
    1531186-2014-05192
    Date Received
    October 30, 2014
    Report Date
    October 10, 2014
    Manufacturer
    UNKNOWN
    Product Code
    IKX
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    END USER STATES WHEN CLEANING THE CHAIR OFF, HE SAW A WAVY CRACK RUNNING 6 TO 7 INCHES FROM LEFT TO RIGHT ON THE CHAIR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    695705 DAILY ACTIVITY ASSIST DEVICES 890.5050 IKX UNKNOWN 9781

    Patients

    Seq Age Sex Outcome Treatment
    1 Other