FDA Adverse Event
Malfunction
Summary report: N
SHWR COMMODE 5 IN CASTER 18 INW 9153640951
MDR report key: 4324328
·
Received December 12, 2014
Report
- Report Number
- 1531186-2014-06174
- Event Type
- Malfunction
- Date Received
- December 12, 2014
- Report Date
- November 17, 2014
- Manufacturer
- UNKNOWN
- Product Code
- ILS
- Product Problem
- Yes
- Report Source
- Distributor report
- Reporter Location
- NJ, US
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
HOSPITAL ADVISED HAVE 22 CHAIRS AND FRONT RIGGINGS WERE REPLACED ON THEM.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 810362 | SHWR COMMODE 5 IN CASTER 18 INW 9153640951 | ADAPTOR, HYGIENE | ILS | UNKNOWN | 6891 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |