BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 2844087 · Received November 24, 2012

    Report

    Report Number
    1525712-2012-02367
    Event Type
    Malfunction
    Date Received
    November 24, 2012
    Report Date
    November 24, 2012
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NJ, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4). NO RMA HAS BEEN INITIATED FOR THIS ISSUE. THE OWNER'S MANUAL PART NUMBER 1141450, REV.E(OCT-08)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'S TECHNIQUE WHILE USING THE DEVICE IS UNKNOWN. THE MAINTENANCE HISTORY OF THE DEVICE IS UNKNOWN. THE MALFUNCTION HAS NOT BEEN CONFIRMED.

    Description of Event or Problem · 1

    PROVIDER STATES LIGHTS FLASHING WILL DRIVE FOR A FEW MINUTES AND THEN SHUTS OFF. THE REPORTER WAS CONTACTED FOR ADDITIONAL INFORMATION. I WAS LEARNED THE DEVICE HAS RECENTLY BEEN ISSUED TO THE END USER WHEN THE JOY STICK HAD A ERROR CODE THEY REPLACED JOYSTICK. STILL HAD PROBLEMS WITH CHAIR WHEN THE TECH GUY SAID THAT THE JOYSTICK CABLE NEED TO BE REPLACED THEY REPLACED CABLE NO MORE COMPLAINTS WITH CUSTOMER

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET M91R

    Patients

    Seq Age Sex Outcome Treatment
    1 62 Other