BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SHWR COMMODE 23 IN TIRES 18 INW 9153640949

    MDR report key: 4353930 · Received December 22, 2014

    Report

    Report Number
    1531186-2014-06711
    Event Type
    Malfunction
    Date Received
    December 22, 2014
    Report Date
    November 7, 2014
    Manufacturer
    JIANGSU YUYUE MEDICAL EQUIPMENT & SUPPLY CO., LTD
    Product Code
    ILS
    Product Problem
    Yes
    Report Source
    Distributor report
    Reporter Location
    KS, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    IT HAS BEEN REPORTED BY A PROVIDER THAT THE BACK UPHOLSTERY ON A 6895 SHOWER COMMODE CHAIRIS COMING APART AT THE SEAMS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    840723 SHWR COMMODE 23 IN TIRES 18 INW 9153640949 ADAPTOR, HYGIENE ILS JIANGSU YUYUE MEDICAL EQUIPMENT & SUPPLY CO., LTD 6895

    Patients

    Seq Age Sex Outcome Treatment
    1 Other