BEUDAMED
    FDA Adverse Event Injury Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 1243779 · Received November 24, 2008

    Report

    Report Number
    1525712-2008-00120
    Event Type
    Injury
    Date Received
    November 24, 2008
    Date of Event
    March 12, 2008
    Report Date
    November 21, 2008
    Manufacturer
    INVACARE
    Product Code
    ITI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    MANUFACTURER RECEIVED INFORMATION FROM AN INSURANCE CARRIER THAT USERS CHAIR VEERED TO THE LEFT AND WENT OVER A CURB. USER IS REPORTEDLY LEGALLY BLIND. USER ALLEGEDLY WENT TO THE ER, AND HAS RECEIVED SUBSEQUENT TREATMENT WITH A CHIROPRACTOR. INFORMATION ALSO PROVIDED SUGGESTS THE CHAIR WAS SERVICED PRIOR TO THE ALLEGED INCIDENT. MDR FILED BASED ON INJURY.

    Description of Event or Problem · 1

    WHILE TRAVELING DOWN THE SIDEWALK, THE CHAIR ALLEGEDLY VEERED TO THE LEFT, THE WHEELS LOCKED UP, AND THE CHAIR WENT OVER A CURB. THE CONSUMER ALLEGEDLY LANDED ON HIS WRISTS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 POWERED WHEELCHAIR 890.3860 ITI INVACARE

    Patients

    Seq Age Sex Outcome Treatment
    1 92 YR Required Intervention| S