NON REMOVABLE FOOT/LEGREST 9153645345 T94HE

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 2014-12-29 for NON REMOVABLE FOOT/LEGREST 9153645345 T94HE manufactured by Jumao Healthcare Equipment.

Event Text Entries

[5111845] It has been reported by a dealer that a t94he left legrest wil not elevate.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1531186-2014-06803
MDR Report Key4365045
Report Source*
Date Received2014-12-29
Date of Report2014-10-28
Date Facility Aware2014-10-28
Report Date2014-12-11
Date Reported to FDA2014-12-11
Date Reported to Mfgr2014-12-11
Date Added to Maude2014-12-29
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 NameNON REMOVABLE FOOT/LEGREST 9153645345
Generic NameFOOTREST, WHEELCHAIR
Product CodeIMM
Date Received2014-12-29
Model NumberT94HE
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 2014-12-29

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