FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 2874774 · Received December 16, 2012

Report

Report Number
1525712-2012-03052
Event Type
Malfunction
Date Received
December 16, 2012
Report Date
December 15, 2012
Manufacturer
UNKNOWN
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

(B)(4). THE DEALER REPORTED THAT THE MODEL AND SERIAL NUMBERS MECHANICAL WHEELCHAIR MOTORS WERE LOCKING. THERE WAS NO PATIENT INJURY REPORTED.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 Other