BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL WALKER, ROLLATOR

    MDR report key: 4240639 · Received November 10, 2014

    Report

    Report Number
    1531186-2014-05503
    Date Received
    November 10, 2014
    Report Date
    October 21, 2014
    Manufacturer
    UNKNOWN
    Product Code
    ITJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER CALLED TO REPORT THEIR CUSTOMER IS REPORTING THE BRAKES ARE BROKE ON BOTH SIDES AND THEY RECEIVED IT THAT WAY UNDER ORDER NUMBER, (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    723367 MECHANICAL WALKER, ROLLATOR 890.3825 ITJ UNKNOWN 65650

    Patients

    Seq Age Sex Outcome Treatment
    1 Other