T93AC T93HE

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a * report with the FDA on 2014-12-12 for T93AC T93HE manufactured by Jumao Healthcare Equipment.

Event Text Entries

[19348469] It was reported by dealer that monthly he receives a box of foot plates and elevating leg rests that are broken from a hospital that he sold a high quantity of chairs. The dealer stated the foot plates are cracked and broke.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1531186-2014-06244
MDR Report Key4327364
Report Source*
Date Received2014-12-12
Date of Report2014-11-18
Date Facility Aware2014-11-18
Report Date2014-12-11
Date Reported to FDA2014-12-11
Date Reported to Mfgr2014-12-11
Date Added to Maude2014-12-15
Event Key0
Report Source CodeDistributor report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationMEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location0
Single Use0
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameT93AC
Generic NameFOOTREST, WHEELCHAIR
Product CodeIMM
Date Received2014-12-12
Model NumberT93HE
OperatorLAY USER/PATIENT
Device AvailabilityN
Device Age7 MO
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerJUMAO HEALTHCARE EQUIPMENT
Manufacturer AddressJIASHAN CH


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2014-12-12

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