BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 2140913 · Received June 27, 2011

    Report

    Report Number
    1525712-2011-00300
    Event Type
    Malfunction
    Date Received
    June 27, 2011
    Date of Event
    May 30, 2011
    Manufacturer
    INVACARE
    Product Code
    ITI
    Report Source
    Manufacturer report
    Reporter Location
    AK, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    NO SERIOUS INJURY ALLEGED. MALFUNCTION ALLEGED. THE DEALER ALLEGES PINCHED WIRING AT THE BASE FRAME NEAR THE REAR CASTER CAUSED A FIRE THAT NEEDED TO BE EXTINGUISHED WITH A FIRE EXTINGUISHER. THE CONSUMER WAS DRIVING THE CHAIR INSIDE THE FACILITY AT THE TIME OF THE ALLEGED INCIDENT. ALLEGEDLY, A THERAPIST SAW FLAMES AND SMOKE COMING FROM THE CHAIR, REMOVED THE CONSUMER WITH NO INJURY AND EXTINGUISHED THE FIRE. FILING MDR.

    Description of Event or Problem · 1

    THE DEALER ALLEGES THE WIRING WAS PINCHED AT THE BASE FRAME NEAR THE REAR CASTER, WHICH ALLEGEDLY CAUSED A FIRE THAT NEEDED TO BE EXTINGUISHED WITH A FIRE EXTINGUISHER. THE CONSUMER WAS OPERATING THE CHAIR AT THE TIME OF THE ALLEGED INCIDENT. NO INJURY IS ALLEGED.

    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 60