D
Patient 1
PT WAS ISSUED A BASIC ROLLATOR OF ACCESS POINT MEDICAL THROUGH FIRST CHOICE MEDICAL SUPPLY. IN 2007, THE WHEELS ON THE WALKER MALFUNCTIONED CAUSING PT TO FALL INCURRING MULTIPLE INJURIES.
MAUDE MDR 937117
- MDR report key
- 937117
- Report number
- 3005009085-2007-00010
- Event key
- 0
- Event type
- 3
- Date of event
- 2007-06-04
- Date received
- 2007-11-02
- Adverse event
- 3
- Product problem
- 3
- Patients in event
- 0
- Reporter occupation
- 0
- Health professional
- 3
- Initial report to FDA
- 3
- Event location
- 0
Manufacturer Contact#
- Contact
- TAMMI SEELE- CONTROLLER
- Address
- PO BOX 411783 ST. LOUIS MO 63141 US
- Phone
- 877-877-8772
- Report source
- M
- Manufacturer link flag
- Y
Devices#
| Seq | Brand | Generic | Manufacturer | Product code | Model | Catalog | Lot | PMA | 510(k) | Implant | Evaluated | Availability |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | ACCESS POINT MEDICAL, LLC | BASIC ROLLATOR | ACCESS POINT MEDICAL, L.L.C. | ITJ | UNK CURRENTLY | UNK CURRENTLY | N | R | N |
Patients#
| Sequence | Received | Treatment | Outcome |
|---|---|---|---|
| 1 | 2007-11-02 | 0 | 1. O |
Event Narratives#
N
Patient 1
IF PRODUCT IS RETURNED OR ADDITIONAL INFO IS RECEIVED, WE WILL SUBMIT AN UPDATED MDR REPORT AT THAT TIME.