BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 2930570 · Received January 28, 2013

    Report

    Report Number
    1525712-2013-00625
    Event Type
    Malfunction
    Date Received
    January 28, 2013
    Report Date
    January 25, 2013
    Manufacturer
    UNKNOWN
    Product Code
    IOR
    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 STATES CROSSBRACE IS BROKEN. THERE WAS NO INJURY. THE DEVICE IS APPROXIMATELY 14 YEARS OLD.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    36650 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR UNKNOWN ALLEGRO

    Patients

    Seq Age Sex Outcome Treatment
    1 Other