MalfunctionITJ

NOVA

Received May 1, 2006 · Event occurred Apr 27, 2006

Report MW1038940 · MDR key 716520

Device

Generic name

4 Wheeled Walker With Seat Cruiser Deluxe

Manufacturer

Nova Ortho Med, Inc.

Model number

Catalog number

Lot number

Product problems

Component(s), broken

Patient

83 YR

Abrasion
Fall

Narrative

Description of Event or Problem

RESIDENT WAS AMBULATING WITH WALKER IN ROOM. RIGHT BACK LEG ON WALKER BROKE AND RESIDENT FELL TO FLOOR. ABRASIONS TO KNEES AND RIGHT HAND. THE WALKER LEG FAILED JUST BELOW THE WELD FOR THE CROSS SUPPORT FOR THE SEAT.