BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 2863688 · Received December 10, 2012

    Report

    Report Number
    3004493922-2012-00640
    Event Type
    Malfunction
    Date Received
    December 10, 2012
    Report Date
    December 7, 2012
    Manufacturer
    INVACARE SUZHOU
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CT, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    RIGHT MOTOR SKIPPING BUT DUE TO AGE SUGGESTED TO REPLACE IN PAIR. IN SPEAKING WITH THE REPORTER IT WAS LEARNED THE CHAIR EXHIBITED JERKY MOTION AND WAS PULLING TO THE RIGHT DUE TO THE LEFT MOTOR OVERPOWERING THE RIGHT AS THE RIGHT WAS SKIPPING. IT WAS YOUR TECHNICAL REP THAT SUGGESTED REPLACING BOTH LT AND RT MOTORS TO MAINTAIN AN EVEN BALANCE OF POWER. NO INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 POWERED WHEELCHAIR 890.3860 ITI INVACARE SUZHOU M41

    Patients

    Seq Age Sex Outcome Treatment
    1 Other