BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 2912197 · Received January 11, 2013

    Report

    Report Number
    1525712-2013-00258
    Event Type
    Malfunction
    Date Received
    January 11, 2013
    Date of Event
    December 12, 2012
    Report Date
    January 10, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    AN END USER HAS CALLED AND REPORTED AN INCIDENT OF HIS CHAIR WAS SMOKING IN THE BACK OF HIS POWERED WHEELCHAIR. IN SPEAKING WITH THE END USER IT WAS LEARNED AS HE WAS LEAVING THE BUS THE SMOKE WAS REPORTED TO HIM BY ANOTHER PASSENGER. A WIRE THAT GOES INTO THE BATTERY WAS SMOKING. NO FLAME, NO INJURY, OR NO PROPERTY DAMAGE. THE CHAIR WAS STILL WORKING AND NO INJURY IS ALLEGED. A SUPPLEMENTAL REPORT WILL BE FILED WHEN FURTHER INFORMATION IS RECEIVED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    16516 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSP

    Patients

    Seq Age Sex Outcome Treatment
    1 65 Other