BEUDAMED
    FDA Adverse Event Other Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 2040183 · Received March 24, 2011

    Report

    Report Number
    1525712-2011-00136
    Event Type
    Other
    Date Received
    March 24, 2011
    Date of Event
    March 3, 2011
    Report Date
    March 24, 2011
    Manufacturer
    INVACARE
    Product Code
    ITI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MO, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    THERE IS NO INJURY REPORTED. DEALER WAS REPORTEDLY REPAIRING A CHAIR FOR THE CONSUMER WHEN THE EVENT OCCURRED. NATURE OF COMPLAINT SUGGESTS A POTENTIAL SERVICE ERROR. MALFUNCTION IS NOT CONFIRMED. MDR FILED SOLELY ON THE DEALER'S COMMENT THE CONTROLLER WAS SMOKING.

    Description of Event or Problem · 1

    WHEN THE DEALER WAS REPAIRING THE CHAIR FOR THE CONSUMER WHEN THE CONTROLLER ALLEGED STARTED SMOKING. NO INJURY IS ALLEGED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 POWERED WHEELCHAIR 890.3860 ITI INVACARE M91 POWER CHAIR

    Patients

    Seq Age Sex Outcome Treatment
    1