BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 2923439 · Received January 22, 2013

    Report

    Report Number
    3004493922-2013-00146
    Event Type
    Malfunction
    Date Received
    January 22, 2013
    Report Date
    January 18, 2013
    Manufacturer
    INVACARE SUZHOU
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    VA, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    END USER STATES HER CHAIR IS LEAKING GREASE (MOTOR) (P/N 1163475) REPLACING MOTOR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    29398 POWERED WHEELCHAIR 890.3860 ITI INVACARE SUZHOU M51

    Patients

    Seq Age Sex Outcome Treatment
    1 Other