MAUDE Adverse Event Report: UNKNOWN DUAL RELEASE PADDLE WALKER... 9153641726; WALKER, MECHANICAL

Model Number G6291-5F

Device Problems Bent (1059); Device Inoperable (1663); Out-Of-Box Failure (2311)

Patient Problem No Information (3190)

Event Type  malfunction  

Event Description

Per (b)(6) (tbm), the va reported to them that each one of the units won't lock and are bent.Out of box failure.

• Brand Name: DUAL RELEASE PADDLE WALKER... 9153641726
• Type of Device: WALKER, MECHANICAL
• Manufacturer (Section D): UNKNOWN; OH
• Manufacturer (Section G): UNKNOWN; OH
• Manufacturer Contact: kevin guyton ; one invacare way; elyria, OH 44035 ; 8003336900
• MDR Report Key: 4655549
• MDR Text Key: 5607139
• Report Number: 1525712-2015-02204
• Device Sequence Number: 1
• Product Code: ITJ
• Combination Product (y/n): N
• Reporter Country Code: US
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Distributor
• Reporter Occupation: Medical Equipment Company Technician/Representative
• Type of Report: Initial
• Report Date: 03/24/2015

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Lay User/Patient
• Device Model Number: G6291-5F
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: No
• Initial Date Manufacturer Received: 03/24/2015
• Initial Date FDA Received: 04/03/2015
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Is the Device Single Use?: No
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Reuse
• Patient Sequence Number: 1
• Patient Outcome(s): Other