BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SHWR COMMODE 23 IN TIRES 18 INW 9153640949

    MDR report key: 4353894 · Received December 22, 2014

    Report

    Report Number
    1531186-2014-06681
    Event Type
    Malfunction
    Date Received
    December 22, 2014
    Report Date
    December 2, 2014
    Manufacturer
    YUYUE
    Product Code
    ILS
    Product Problem
    Yes
    Report Source
    Distributor report
    Reporter Location
    CA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PER DEALER THE SWING AWAY ARM LATCH ASSEMBLY FELL OFF.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    840957 SHWR COMMODE 23 IN TIRES 18 INW 9153640949 ADAPTOR, HYGIENE ILS YUYUE 6895

    Patients

    Seq Age Sex Outcome Treatment
    1 Other