FDA Adverse Event
Malfunction
Summary report: N
SHWR COMMODE 23 IN TIRES 18 INW 9153640949
MDR report key: 4365221
·
Received December 29, 2014
Report
- Report Number
- 1531186-2014-06799
- Event Type
- Malfunction
- Date Received
- December 29, 2014
- Report Date
- November 12, 2014
- Manufacturer
- JIANGSU YUYUE MEDICAL EQUIPMENT & SUPPLY CO., LTD
- 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
IT HAS BEEN REPORTED BY A DEALER THAT THE WHEELS BEARINGS ARE BAD ON A 6895 SHOWER COMMODE CHAIR.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 853812 | 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 |