BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 2890377 · Received December 29, 2012

    Report

    Report Number
    1525712-2012-03367
    Event Type
    Malfunction
    Date Received
    December 29, 2012
    Report Date
    November 30, 2012
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4) ISSUED MFR. REPORT # 1525712-2012-03367 INDICTING THE MODEL AS A 3GTQ3-CG POWERED WHEELCHAIR WHEN THE ACTUAL MODEL IS A CT6A MANUAL WHEELCHAIR. THE MANUFACTURER STAYS THE SAME.

    Description of Event or Problem · 1

    DEALER ALLEGES BEARING WAS CORRODED. NO INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVACARE TAYLOR STREET CT6A

    Patients

    Seq Age Sex Outcome Treatment
    1 Other