FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 2802258 · Received October 23, 2012

Report

Report Number
1525712-2012-01911
Event Type
Malfunction
Date Received
October 23, 2012
Report Date
October 21, 2012
Manufacturer
INVACARE TAYLOR STREET
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

(B)(4) - NO RMA HAS BEEN INITIATED FOR THIS ISSUE. MODEL PATRIOT, SERIAL NUMBER/DATE CODE (B)(4) IS APPROXIMATELY ONE MONTH OLD. THE OWNER'S MANUAL PART NUMBER 1088909 REV. E (FEB-09) WAS ISSUED WITH THIS DEVICE. THE OWNER'S MANUAL IS ALSO FOUND ON-LINE AT INVACARE.COM. IT IS UNKNOWN IF THE CONSUMER HAS FULLY READ AND UNDERSTANDS THE OWNER'S MANUAL. DOCUMENTATION PROVIDES WARNINGS, CAUTIONS, AND INSTRUCTIONS FOR SAFELY USING THE DEVICE. IF THE CONSUMER DOES NOT UNDERSTAND THE WRITTEN WARNINGS, CAUTIONS OR INSTRUCTIONS THEN THEY SHOULD CONTACT INVACARE. THE CONSUMER IS AGE, HEIGHT AND WEIGHT ARE UNKNOWN. THE CONSUMER'S MEDICAL CONDITION, STABILITY AND MEDICATION REGIMEN ARE UNKNOWN. THE CONSUMER'S TECHNIQUE WHILE USING THE DEVICE AND THE MAINTENANCE HISTORY OF THE DEVICE ARE UNKNOWN. THE MALFUNCTION HAS NOT BEEN CONFIRMED.

Description of Event or Problem · 1

(B)(4) - THE DEALER REPORTED THAT THE PATRIOT MECHANICAL WHEELCHAIR HAND RIMS WERE VERY SLIPPERY, AND THE UNIT WAS DIFFICULT TO PROPEL. THERE WAS NO REPORTED PATIENT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVACARE TAYLOR STREET PATRIOT

Patients

Seq Age Sex Outcome Treatment
1 Other