FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 2862594 · Received December 10, 2012

Report

Report Number
9616091-2012-00618
Event Type
Malfunction
Date Received
December 10, 2012
Report Date
December 7, 2012
Manufacturer
INVAMEX
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

RUBBER COMING OFF OF RIM. NO INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVAMEX T424RDA

Patients

Seq Age Sex Outcome Treatment
1 Other