BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BATH AND SHOWER CHAIR

    MDR report key: 4360712 · Received December 16, 2014

    Report

    Report Number
    MW5039738
    Event Type
    Injury
    Date Received
    December 16, 2014
    Date of Event
    December 15, 2014
    Report Date
    December 16, 2014
    Manufacturer
    NOVA
    Product Code
    KMN
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    SHOWER CHAIR LEGS BENT AND PLASTIC SEAT STARTED TO COLLAPSE WHEN I WAS SITTING ON THE CHAIR FOR MY SHOWER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    823448 BATH AND SHOWER CHAIR BATH AND SHOWER CHAIR KMN NOVA 9121

    Patients

    Seq Age Sex Outcome Treatment
    1 60 YR Required Intervention