BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ASPIRATOR MOBILAIRE 9153619936

    MDR report key: 4362447 · Received December 26, 2014

    Report

    Report Number
    1531186-2014-06824
    Event Type
    Malfunction
    Date Received
    December 26, 2014
    Report Date
    December 4, 2014
    Manufacturer
    EMG TECHNOLOGY CO. LTD
    Product Code
    DWM
    Product Problem
    Yes
    Report Source
    Distributor report
    Reporter Location
    IL, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    END USER STATED THAT KNOB CAME OFF BECAUSE THE UNDERNEATH CONNECTIONS HAS BEEN STRIPPED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    851882 ASPIRATOR MOBILAIRE 9153619936 APPARATUS, SUCTION, SINGLE PATIENT USE, PORTABLE, NONPOWERED DWM EMG TECHNOLOGY CO. LTD IRC1135

    Patients

    Seq Age Sex Outcome Treatment
    1 Other