BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 2901770 · Received January 8, 2013

    Report

    Report Number
    1525712-2013-00186
    Event Type
    Malfunction
    Date Received
    January 8, 2013
    Report Date
    January 7, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NC, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    (B)(4). THE DEALER REPORTED THAT THE 3GTQ-TS POWER WHEELCHAIR TILT ACTUATOR CABLE WAS DAMAGED. THERE WAS NO PATIENT INJURY REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    9062 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET 3GTAQ-TS

    Patients

    Seq Age Sex Outcome Treatment
    1 Other