BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ALL-IN-ONE-ALUMINUM COMMODE 4 PER CARTON 9153637754

    MDR report key: 4664644 · Received April 7, 2015

    Report

    Report Number
    9616091-2015-00985
    Event Type
    Malfunction
    Date Received
    April 7, 2015
    Report Date
    March 17, 2015
    Manufacturer
    INVAMEX
    Product Code
    ILS
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    (B)(4). DLR STATES THAT HE SOLD 3 CASES OF THE 9650-4 ALUMINUM COMMODES AND THE USER STATES THAT THE SEAT COMES OFF ALL THE TIME. REPLACING P/N 1112182 SEAT WITH LID. (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    228220 ALL-IN-ONE-ALUMINUM COMMODE 4 PER CARTON 9153637754 ADAPTOR, HYGIENE ILS INVAMEX 9650-4

    Patients

    Seq Age Sex Outcome Treatment
    1 Other