HEAVY DUTY ROLLATOR
Received May 15, 2018 · Event occurred Apr 13, 2018
Report 1423537-2018-00200 · MDR key 7514579
Device
Generic name
Walker, Mechanical
Manufacturer
Jan Mao Industries Co. Ltd.Model number
ZCHCRL0009BCatalog number
ZCHCRL0009B
Lot number
8400005140SB
Product problems
- Break
- Break
Patient
Not reported
- Fall
- Fall
Narrative
Additional Manufacturer Narrative
BASED ON THE SUPPLIER¿S INVESTIGATION, THE DEVICE HISTORY RECORD REVIEW DID NOT INDICATE ANY EXCEPTION THAT COULD HAVE LED TO THE REPORTED INCIDENT. THE SUPPLIER REVIEWED THE DEVICE MASTER RECORD AND THERE WERE NO DESIGN CHANGES, PRODUCTION PROCESS CHANGES OR MATERIAL CHANGES. THEY RECEIVED AND REVIEWED PHOTOS AND OBSERVED THAT THE RIGHT FRONT WHEEL OF THE ROLLATOR IS SEPARATED FROM THE MAIN BODY AND BROKEN FROM THE FIXED BOLT POSITION. AS THE DEVICE INVOLVED IN THIS INCIDENT WAS NOT AVAILABLE FOR FURTHER INVESTIGATION, THE ROOT CAUSE FOR THE REPORTED ISSUE COULD NOT BE DETERMINED. THE COMPLAINT INFORMATION WAS PROVIDED TO THE RELEVANT SECTORS FOR THEIR AWARENESS. NO ADDITIONAL ACTION WILL BE TAKEN AT THIS TIME. IF THE DEVICE BECOMES AVAILABLE FOR EVALUATION THE COMPLAINT INVESTIGATION WILL BE REOPENED.
Description of Event or Problem
THE PATIENTS¿ DAUGHTER, (B)(6) CALLED, CLAIMING THE WHEEL ON THE ROLLATOR REPORTEDLY BROKE AND SUBSEQUENTLY THE PATIENT FELL, BUT HE WAS NOT INJURED. SHE REPORTED THAT HER FATHER WEIGHS LESS THAN 350 POUNDS, BUT PROVIDED NO OTHER INFORMATION.