BEUDAMED
    FDA Adverse Event Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 2893579 · Received January 2, 2013

    Report

    Report Number
    1525712-2013-00010
    Date Received
    January 2, 2013
    Report Date
    January 1, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WI, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4) 2014 - THIS REPORT IS FOLLOW UP 001 TO COMPLETE THE INFORMATION.

    Description of Event or Problem · 1

    PROVIDER STATES THE ELEVATE NOT WORKING. NO INJURY.

    Description of Event or Problem · 1

    PROVIDER STATES THE ELEVATE NOT WORKING. NO INJURY.

    Devices

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

    Patients

    Seq Age Sex Outcome Treatment
    1 Other