BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    DAILY ACTIVITY ASSIST DEVICES

    MDR report key: 4213540 · Received October 30, 2014

    Report

    Report Number
    1525712-2014-07401
    Event Type
    Malfunction
    Date Received
    October 30, 2014
    Report Date
    October 7, 2014
    Manufacturer
    UNKNOWN
    Product Code
    ILS
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    END USER ADVISED SEAT IS NOT STAYING IN ONE PLACE AND BACK IS LOOSE ON COMMODE. END USER COULD NOT PROVIDE MODEL NUMBER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    694956 DAILY ACTIVITY ASSIST DEVICES 890.5050 ILS UNKNOWN SELFCARE

    Patients

    Seq Age Sex Outcome Treatment
    1 Other