MAUDE MDR 3203593

MDR report key
3203593
Report number
1531186-2013-02932
Event key
0
Event type
3
Date received
2013-07-03
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
305
Health professional
3
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1WHEELCHAIR ACCESSORY890.3910NEW PROKININER100* N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12013-07-0301. O

Event Narratives#

D

Patient 1

IT WAS REPORTED THE R100 SLING HAS A TORN STRAP.