BEUDAMED
    FDA Adverse Event Summary report: N

    *

    MDR report key: 4486556 · Received January 12, 2015

    Report

    Report Number
    4486556
    Date Received
    January 12, 2015
    Date of Event
    December 15, 2014
    Report Date
    January 12, 2015
    Manufacturer
    MEDICAL DEPOT D/B/A DRIVE MEDICAL DESIGN AND MANUFACTURING
    Product Code
    ILS
    Report Source
    User Facility report
    Reporter Location
    MI, US

    Narratives

    Description of Event or Problem · 1

    PT PURCHASED A 3-IN-1 COMMODE PRIOR TO DISCHARGE. THEY TOOK IT HOME AND SAT DOWN TO USE AND THE SEAT WAS NOT PROPERLY ALIGNED SO THE PT CUT HERSELF ON HER BACK SIDE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    24817 * COMMODE CHAIR ILS MEDICAL DEPOT D/B/A DRIVE MEDICAL DESIGN AND MANUFACTURING * *

    Patients

    Seq Age Sex Outcome Treatment
    1 90 YR NO OTHER DEVICES USED