FDA Adverse Event
Malfunction
Summary report: N
POWERED WHEELCHAIR
MDR report key: 2923658
·
Received January 22, 2013
Report
- Report Number
- 1525712-2013-00531
- Event Type
- Malfunction
- Date Received
- January 22, 2013
- Report Date
- January 20, 2013
- Manufacturer
- INVACARE TAYLOR STREET
- Product Code
- ITI
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- OH, US
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
DEALER STATED THAT THE M91 POWER CHAIR STOPPED ON IT'S OWN, YELLOW LIGHT WAS FLASHING.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 30283 | POWERED WHEELCHAIR | 890.3860 | ITI | INVACARE TAYLOR STREET | M91 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |