BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 2874530 · Received December 14, 2012

    Report

    Report Number
    1525712-2012-03004
    Event Type
    Malfunction
    Date Received
    December 14, 2012
    Report Date
    December 14, 2012
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    HOSPITAL SERVICE TECHNICIAN

    Narratives

    Description of Event or Problem · 1

    A USER FACILITY HAS CALLED IN TO REPORT AN EVENT OF THE MOTORS KEEP LOCKING UP. NO INJURY. IT WAS LEARNED THAT THE MOTORS WILL BE REPLACED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET 3GRX

    Patients

    Seq Age Sex Outcome Treatment
    1 Other