BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    WHEELCHAIR COMPONENTS

    MDR report key: 2930508 · Received January 28, 2013

    Report

    Report Number
    1525712-2013-00597
    Event Type
    Malfunction
    Date Received
    January 28, 2013
    Report Date
    January 25, 2013
    Manufacturer
    UNKNOWN
    Product Code
    INM
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NE, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER STATED THAT THE T93HA FOOTREST FOR A MANUAL WHEELCHAIR ARE ALLEGEDLY CRACKED/BROKEN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    36950 WHEELCHAIR COMPONENTS 890.3920 INM UNKNOWN T93HE

    Patients

    Seq Age Sex Outcome Treatment
    1 Other