BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 2884169 · Received December 21, 2012

    Report

    Report Number
    1525712-2012-03207
    Event Type
    Malfunction
    Date Received
    December 21, 2012
    Report Date
    December 20, 2012
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATES THAT FIRST IT WOULD NOT TURN OFF THEN IT WOULD NOT TURN ON AND IS WORKING NOW. NO INJURY. PLEASE NOTE ANY FURTHER INFORMATION RECEIVED WILL BE PROVIDED IN A SUPPLEMENTAL REPORT.

    Devices

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

    Patients

    Seq Age Sex Outcome Treatment
    1 Other