BEUDAMED
    FDA Adverse Event Injury Summary report: N

    INVACARE POWER WHEELCHAIR

    MDR report key: 1140237 · Received August 29, 2008

    Report

    Report Number
    1525712-2008-00079
    Event Type
    Injury
    Date Received
    August 29, 2008
    Report Date
    August 29, 2008
    Manufacturer
    INVACARE CORPORATION - MANUFACTURING FACILITY
    Product Code
    ITI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    NO INFORMATION

    Narratives

    Additional Manufacturer Narrative · 1

    MANUFACTURER CONTACTED USER AND FACILITY THAT HAD SERVICED THE CHAIR FOR THE USER. INFORMATION INDICATES THE CHAIR WAS NOT SERVICED PROPERLY RESULTING IN THE CHAIR'S SEAT COMING OFF THE BASE. NO MALFUNCTION APPARENT.

    Description of Event or Problem · 1

    THE CONSUMER ALLEGES HIS SEAT CAME OFF THE BASE, CAUSING HIM TO FALL AND BREAK HIS FOOT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 INVACARE POWER WHEELCHAIR 890.3860 ITI INVACARE CORPORATION - MANUFACTURING FACILITY 3GAR NA

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention